Background: Vertigo imposes considerable health restrictions with significant impact on the patient's quality of life. The most effective antivertigo agent is undetermined thus far. Objective: This study was performed to assess whether promethazine has superior vertigo reduction compared with lorazepam in ED patients. Methods: In this randomized, double-blind, parallel group trial 184 patients were assigned (1:1 ratio) to receive either promethazine, 25 mg intravenously, or lorazepam, 2 mg intravenously. Primary endpoint was mean change in vertigo intensity at 2 hours measured using visual analog scale (VAS). Secondary endpoints were mean change in nausea score, need for second dose of study medications, and adverse events (AEs). Results: Promethazine was associated with significantly more reduction (46.5 mm) in vertigo than lorazepam (25.7 mm, p< 0.001). Mean change in nausea score 2 hours after drug injection on the VAS was 28.7 mm for promethazine and 22.8 for lorazepam (p=0.002). The most frequently reported AEs were lethargy (14.1% in lorazepam group, 4.3% in promethazine group, p=0.013) and drowsiness (10.8% for promethazine, 2.1% for lorazepam, p=0.017). Conclusion: Our study demonstrated the evidence that promethazine is superior to lorazepam in management of peripheral vertigo and vertigo-related nausea in ED adults.

In this research, biostratigraphy, microfacies analysis and sequence stratigraphic framework of the Asmari Formation are discussed at Sepidar Anticline, Interior Fars sub-Basin. The strata are Rupelian to Chattian in age. According to the distribution of benthic foraminifera, two assemblage zones were recognised (I-) Nummulites vascus–Nummulites fichteli and (II-) Archaias asmaricus/hensoni–Miogypsinoides complanatus. Eight microfacies types which can be grouped into three depositional environments are recognised. Distribution of Oligocene foraminifera together with other constituents allowed the identification of three third-order sequences at Asmari Formation. Correlation of analysed sections through Interior Fars sub-Basin represents the development of a carbonate ramp with a deepening trend from SE to NW along the Rupelian/Chattian boundary.