Because there was a significant correlation between VAS pain scale and salivary alpha-amylase, we suggest that this biomarker may be a good index for the objective assessment of pain intensity. In addition, a simple to use portable analyzer may be useful for such assessment.

No abstract

No abstract

Sirs: Bell's palsy has been associated with non-insulin-dependent diabetes mellitus (NIDDM) [12] or hypertension [6,16]. Certain studies have also indicated that the prognosis of NIDDM can be worse than that in the general population [3,9,15], although such findings have been disputed [1,14]. Since it has been estimated that approximately 40% of patients with NIDDM are hypertensive [13], Blunt [2] suggested that vascular factors were most likely related to the prognosis of patients with Bell's palsy. We have a study to determine whether an association with NIDDM and/or hypertension worsens the recovery of Bell's palsy.Sixty-eight Bell's palsy patients (34 males, 34 females), ranging in age from 40 to 55 years, were allocated to one of four groups after informed consent. Group I was the control group and consisted of 24 patients with Bell's palsy alone. Group II consisted of 14 patients with essential hypertension (defined as a systolic blood pressure > 160 mm Hg and/or a diastolic blood pressure > 95 mm Hg). Group III contained 18 patients with NIDDM (as demonstrated by a fasting plasma blood glucose ≥ 140 mg dl -1 , 2 h postchallenge glucose levels of ≥ 200 mg dl -1 and glycosylated hemoglobin > 8.0%). Group IV included 12 patients with both NIDDM and hypertension. For treatment of Bell's palsy, all patients received oral prednisolone within 3 days from the onset of the palsy with care taken in the NIDDM and hypertensive patients to not worsen either disease. The daily dose of prednisolone was 1 mg kg -1 in three divided doses for 6 days. The dose was reduced gradually over the next 6 days and stopped after 12 days of treatment. The effect of the treatment was assessed by the 40-point "palsy score" devised by Yanagihara [16] and the House-Backmann grading system [8]. Doubleblind evaluations were carried out every 3 days for the first 3 weeks and then every 2 weeks. Electroneurography (ENoG) was employed according to the method proposed by Fish [7], using NEC Sanei Co Synax Model 1202 (Tokyo, Japan). Stimulating electrodes were positioned horizontal to the posterior plate located over the mastoid tip. The recording electrodes were placed with the superior plate adjacent to the alar margin of the nasolabial fold. A constant voltage stimulator was used to deliver stimulating pulses at 100 ms. Data were expressed as the mean ± SEM. Palsy score and ENoG among the groups were analyzed by ANOVA and the Bonferroni test. Change in data over time within each group was determined by the paired Student's t-test. Differences in mean values were considered significant at a value of P < 0.05.Findings showed that there were no significant differences in ages or weights or in the interval from the onset of paralysis to treatment. Nine patients demonstrated > 90% degeneration on ENoG, while fifty-nine patients had < 90% degeneration. Among the nine patients with > 90% degeneration, NIDDM was presented in one patient and hypertension in two patients. Two other patients had both NIDDM and hypertension. The blood glucose of the NID...