dr. farhad farahani

 

Background and Aim:

 Inner ear infection with some viruses may be one of the possible causes of Sensorineural Hearing Loss (SNHL). This study aims to determine the frequency of Herpes Simplex Virus 1 and 2 (HSV-1, HSV-2) and Cytomegalovirus (CMV) in perilymph and peripheral blood samples of cochlear-implanted children.

Methods: 

In this cross-sectional study, 30 children with severe-to-profound SNHL (aged 1.1–5 years) underwent cochlear implantation surgery. During surgery, their perilymph and peripheral blood samples were collected. The samples were analyzed separately for the presence of herpes HSV-1, HSV-2, and CMV by real-time Polymerase Chain Reaction (PCR) method. The load of IgG and IgM antibodies against these viruses was determined using the Enzyme-Linked Immunosorbent Assay (ELISA) method.

Results: 

The frequency of CMV in perilymph samples was 16.7% (5 patients) and in peripheral blood samples was 3.3% (1 patient). The IgG antibody against CMV and HSV- 1 was positive in 80% and 46.7% of the patients, respectively. The IgM antibody against CMV was positive in 10%. The mean IgM serum antibody load against HSV-1, HSV-2, and CMV was 2.70, 1.70, and 5.47, respectively, and the mean IgG antibody load against these viruses was 56.07, 2.50, and 23.67, respectively.

Conclusion: 

The IgG test is positive in cochlear-implanted children with CMV in their perilymph samples, and the CMV genome is not present in their peripheral blood. This may indicate the previous presence of this virus in the ear and its role in hearing loss.

International relation's arena is extremely effected of cultural and identity ingredients. So gain an aspect and international prestige, penetrate in public opinion and access to soft power are the important and at the same time unspecified goals is the diplomacy of countries. China's emerging power is trying to export its cultural industries and penetrate as deeply as possible in the MiddleEast in order to strengthen its soft power.The importance of this Chinese strategy can be seen in the cooperation document with Iran.At the same time, the identity and cultural opportunities contained in this agreement have the potential to expand Iran's soft power in the international system.Therefore, the purpose of this study is with descriptive-explanatory method and using library texts and available data to answer the main question, how does China's cultural exports to the Middle East and the cultural opportunities of the Iran-China Cooperation Agreement highlight the role of soft power in international relations?This hypothesis is raised in response to this question: China's investment in the distribution of identity products in the Middle East and the cultural opportunities resulting from the 25-year cooperation agreement for Iran, express the need for governments to pay attention to the concept of soft power.

The progress of cardiac surgery in children and the increase in the survival of children with Congenital Heart Disease (CHD) has led to consider another issue called a neurodevelopmental disorder. In this study, 53 children with CHD were evaluated in terms of development with the Essence Q questionnaire, Otoacoustic Emission (OAE), and Auditory Brainstem Response (ABR) regarding these patients’ hearing and risk factors. The Essence Q scores were also examined

In this prospective, cross-sectional study, the researchers included 53 children diagnosed with CHD. Initially, each child underwent ABR and OAE tests. Subsequently, data on potential risk factors associated with neurodevelopmental delay were collected. A trained project associate administered the Essence Q questionnaire, using parents’ information as a guide. Following data collection, this study proceeded with an in-depth analysis of the information.

Thirty-six boys (67.92%) and 17 girls (32.08%) with CHD were included in the study. The mean age of children was 2/23+_8.11. The mean Essence Q score for boys was 7.48+_2.57.
Moreover, the average score for girls was 2.23 8.11. According to this questionnaire, 39 patients (73.58%) had hyperactivity disorder,46 patients (86.79%) had behavioral disorders, and ten patients (16.98%) had a motor delay. Unlike previous studies, all patients had normal OAE and ABR hearing.

This study demonstrated that factors such as developmental delay in the first year, a known genetic disease, and a history of seizures significantly impacted the Essence Q score. However, elements like prematurity, the use of ventilation, abnormalities on the dorsum, and the number of days post surgery did not significantly affect the Essence Q score. Essence Q can be a reliable tool in screening for neurodevelopment in children with CHD

 Rural areas have always been exposed to natural and man-made hazards while they are of special importance due to providing and distribution of countries' food security so that in rural reform projects, the principles of passive defense should be taken into account. In this regard, this study aimed to analyze the role of the passive defense principle on rural regeneration plans of suburban areas.

 This is a descriptive-analytical research and practical applied in terms of objectives. Data were collected using questionnaires and library studies and analyzed through Kolmogorov-Smirnov test, factor analysis, Spearman's correlation coefficients, and coefficients of variation using SPSS software.

 The factor analysis test showed that the principles of strengthening and securing vital structures and selecting the optimal scale of dispersion and economic justification of projects have the most and least compatible with rural regeneration plans in Fardis village. The results of Pearson's correlation coefficient test showed that the success of rural regeneration plans in order to achieve the principles of passive defense is evident in the principles of strengthening and securing vital structures. Finally, the results of the variation coefficients and percentage distribution of the items showed a higher percentage of regeneration in the economic, social, environmental, and physical dimensions of most of the items from medium to high ranks.

A prerequisite for the successful regeneration of worn-out rural texture is the integration of sectoral approaches, emphasizing the principles of passive defense.

Oxidative stress is one of the causes of tinnitus. The therapeutic effect of nanocurcumin on the antioxidant processes of various diseases has been confirmed; however, no study, to the best of our knowledge, has been conducted on its therapeutic effect on tinnitus. Therefore, the present study aimed to determine the effect of nanocurcumin on treating tinnitus.

This study was a randomized controlled trial (triple-blind intervention). A total of 62 patients with tinnitus were selected by randomized block design with observance of concealment. Then, the participants were divided into two groups of 31 and were treated with nanocurcumin and a placebo. Both groups were similar in terms of age and gender with frequency matching methods. Hearing tests were performed for all patients. Patients received 80 mg/day of nanocurcumin and similar placebo capsules for 21 days.

The mean and standard deviation of the age in the nanocurcumin and placebo groups were 44/77 ± 15/2 and 46/32 ± 15/2 years, respectively (P>0.05). The difference between the mean duration of tinnitus was not significant in both groups (P>0.05). The results indicated that the antioxidant nanocurcumin reduced the tinnitus score (P=0.02). However, nanocurcumin failed to affect the frequency, high score, degree of annoyance, mean score of speech discrimination, and speech reception threshold (P>0.05). Also, no side effect was reported from using nanocurcumin.

Nanocurcumin is not effective in the treatment of tinnitus.

Urban regeneration from the point of view of non -active defense means reducing the vulnerability of buildings, facilities, equipment and urban and regional arteries through natural hazard management and social mobilization (popular participation) in reducing damages related to inefficient tissues. Be In this regard, the aim of the present study is to analyze the effective factors in achieving the principles of passive defense in the regeneration plans of Qarchak city using grounded theory. In terms of the purpose, the current research is part of the fundamental and descriptive researches, and in terms of the method, it is included in the group of qualitative researches. The sample size for interviewing experts in the framework of final theoretical saturation using targeted sampling, 18 experts (experts, university professors and city managers of Qarchak) were selected. The grand theory method was also used to analyze the data. The result of interviews with experts to analyze the effective factors in achieving the principles of passive defense in regeneration plans in Qarchak city using contextual theory, including 6 core codes (causal, contextual, intervening, strategic conditions) consequences and obstacles). Causal conditions from 5 categories and 16 concepts, contextual conditions from 4 categories and 15 concepts, intervening conditions from 5 categories and 13 concepts, strategies from 3 categories and 11 concepts, consequences from 5 categories and 14 concepts, and finally, the obstacles consist of 7 categories and 17 concepts.

Tinnitus is hearing a sound without an external source, which occurs anywhere in the head and one or both ears. It is one of the most common symptoms associated with hearing loss due to chronic otitis media. This study aimed to determine the effect of autologous primary ossicular reconstruction on the recovery of tinnitus due to chronic otitis media.

This study was conducted based on a before-and-after design and included 25 patients aged 18-70 years with tinnitus and chronic otitis media. The participants had undergone initial reconstruction of the bone chain using an autologous graft in the Department of Ear, Nose, and Throat of the Hamadan Besat Hospital, Hamedan, Iran, in 2019. The Tinnitus Matching Test and the Tinnitus Handicap Inventory were used to assess patients' tinnitus.

A total of 25 patients participated in this study, including 13 (52%) men and 12 (48%) women. The mean scores of the age of the subjects, duration of tinnitus, frequency of tinnitus were obtained at 45.76±12.76 years, 53.25±37.25 months, and 5,000 Hz, respectively. The difference between the mean values of tinnitus loudness was significant before (8 dB) and after the surgery (4 dB) (P<0.001). Moreover, a significant difference (P<0.001) was observed between the scores of the Tinnitus Handicap Inventory before (39.48) and after the surgery (17.84).

Primary reconstruction of the middle ear bone chain using autologous graft improved tinnitus and its resulting disability in patients with chronic otitis media.

The physical growth and development of the metropolis of Tehran over the past few decades has doubled the need to pay attention to the principles of passive defense in the framework of development planning in the surrounding areas. And this attention to the issue of passive defense on the policy and performance of urban plans, especially the reconstruction of worn-out tissue, It had a profound effect. In this regard, the purpose of this study is to Analysis of the Status of passive defense principles in Urban Regeneration Projects of Metropolitan Peripheral Area (Case study: Qarchak city). This research in terms of applied purpose and in terms of the nature and method of research, It's a survey. The data required for the research have been collected by documentary-field method (questionnaire and observation). The statistical population of the present study includes residents of Qarchak dilapidated neighborhoods (Davudabad, Ferdis, Mohammadabad, Mafiabad and Vali Abad) (84855 people), the sample size was determined using Cochran's formula of 383 people. SPSS software was used to analyze the data. The results of t-test in all the studied items according to the average obtained less than number (3), indicate the unsatisfactory status of the reconstruction projects in order to achieve the principles of passive defense in the city of Qarchak. Also, the results of the field study of the area and the study of the documentary sources of the developed plans show the non-observance of the passive defense categories in the urban regeneration plans that have been carried out in recent years (in the target neighborhoods).

Neonatal jaundice is a common cause of premature neonatal hearing loss and is a major cause of childhood deafness, especially in developing countries. The aim of this study was evaluating Hearing threshold of Auditory Brainstem Response (ABR) in term neonates admitted with hyperbilirubinemia at a range of exchange transfusion and near exchange transfusion. This cross-sectional study was performed on 134 healthy term infants admitted due to hyperbilirubinemia in the neonatal care unit of Besat Hospital in Hamadan from March 2017 to September 2017. All neonates were evaluated by Otoacoustic Emission (OAE) and ABR after admission in neonatal ward and after treatment by intensive phototherapy or blood              exchange. Data were collected and analyzed through SPSS software and using Chi-square and Mann-Whitney tests. The significance level was considered at 0.05 for all statistical tests. The mean weight of newborns was 3000 ±350 gr and the mean of gestational age was 39± 2 weeks. Bilirubin concentration of the infants was 36.9±9.2 mg/dL. There was a significant difference between hearing loss on auditory brainstem response in term neonates according to hyperbilirubinemia in blood exchange range (P = 0.001). However, there was no significant difference between hearing loss on auditory brainstem response in term neonates according to the gestational age, sex and phototherapy (P > 0.05). Our findings indicated that high bilirubin levels in the range of exchange transfusion can be an important risk to the auditory system, which without creating kernicterus, can interfere with auditory tests.

Tolosa-Hunt syndrome (THS) is a painful ophthalmoplegia associated with granulomatous inflammation of the cavernous carotid artery and surrounding tissues which responds to corticosteroid. Other causes of painful ophthalmoplegia must be ruled out. We present a case of THS in which the course of the disease suggested this idiopathic condition which occurred after wide mastoidectomy. The patient was diabetic and had a huge pituitary gland adenoma. Partial petrosectomy, laboratory tests, and imaging studies were normal. We named this condition ‘Tolosa-Hunt-Like Syndrome’.

Studies have shown that several factors affect the hearing loss of infants hospitalized in the neonatal intensive care unit (NICU). These factors include hyperbilirubinemia, low birth weight, asphyxia, and prematurity. This study aimed to investigate the prevalence of hearing loss and its risk factors in NICU infants.

This is a cross-sectional study. Samples were 159 infants admitted to the NICU in Fatemieh and Shahid Beheshti hospitals in Hamadan, Iran, who were selected using a convenience sampling method. Their hearing was screened using transient evoked otoacoustic emission (TEOAE) and automated auditory brainstem response (AABR) tests; in case of failure in these tests, auditory brainstem response (ABR) was performed.

Of 159 infants, 9 (5.66%) were identified with different types of hearing loss where 4 (2.51%) had sensory-neural hearing loss, one (0.62%) had auditory neuropathy and 4 (2.51%) had conductive hearing loss. There was a statistically significant relationship between hearing loss and birth weight < 1500 g, hyperbilirubine mia, antibiotic therapy, family history of hearing loss, asphyxia and Apgar score < 5.

Prevalence of hearing loss in NICU infants is noticeable so hearing assessment after discharge is necessary. Due to the presence of auditory neuropathy, simultaneous use of TEOAE and AABR tests in these infants is recommended.

Early detection of neonatal hearing disorders is a suitable measure of speech and behavioral development. The aim of this study was to determine the prevalence of hearing disorder in high-risk neonates treated in a neonatal intensive care unit (NICU).

This descriptive study was performed on 150 neonates treated in the NICU of Besat Hospital in Hamadan, Iran, using a census method. Auditory brainstem response (ABR) and otoacoustic emission (OAE) tests were performed by Labat and HOMOTH devices in Besat Hospital of Hamadan for diagnosis of hearing disorders. Data were analyzed using descriptive statistics and Chi-square test via SPSS 16.

In this paper, 63.3% of studied participants were male and 36.7% were female. Also, 4.7% of participants had mild to severe hearing disorder, and 3.3% had moderately-severe hearing loss. There was a statistically significant relationship between age at admission, hearing loss in both ears, and oxygen demand with hearing-impaired participants (ABR test).

Considering the presence of 4.7% of hearing-impaired neonates (ABR test) in this study, it is necessary to design and implement a comprehensive hearing screening for high-risk neonates in terms of hearing disorders.

Innovation, evaluating, and stabilizing the desirable educational practices are important tasks of the educational system. Accordingly, the purpose of this study is to investigate and compare the effect of in-person and teacher-centered education with virtual education in learning the history of Islamic culture and civilization course of Hamadan Medical Sciences students.

This is an applied study in terms of nature and purpose and a quasi-experimental study. The statistical population consisted of 30 female medical students of Medical Sciences University of Hamadan who chose the book of History of Islamic Culture and Civilization in 2018; they were divided into two groups of 15 to participate in the process of in-person and teacher-centered education, and virtual education for teaching and learning Chapter 10 (Introduction to the basics of Iranian traditional medicine) by simple random allocation method. The evaluation criterion in the learning dimension of the course was the score obtained in the test. The validity of the questionnaire of their attitude toward these two educational methods were evaluated by the professors and experts in this field, and its reliability was confirmed by conducting a guide study and calculating the Cronbach's alpha.

The findings indicated that the students' academic test scores in this course, social cohesion and instructor had been in a better position in-person and teacher-centered teaching method. The mean of other elements such as success, negative affection, spontaneity in learning, opportunity and even overall satisfaction in the in-person method had been higher than the virtual teaching method. The findings show that in the virtual teaching method, the mean of social cohesion and students' satisfaction with the course instructor had been lower than the criterion mean.

From the students' point of view, the presence and interaction with the professor is an essential and important element in the teaching and teaching methods that this interaction will lead to the development of relationships and social cohesion between the students and professor. In addition, the high mean of the test scores in the in-person and teacher-centered methods compared to the virtual method can indicate the shared role of the professor and student in learning.

Cochlear implantation is a cure for hearing impaired or deaf children who can't use hearing aids. Parental attitude to post-cochlear implications can be effective in the process of child rehabilitation. Therefore, the aim of this study was to investigate the parents' attitude towards the consequences of cochlear implantation in children referred to the Besat cochlear implant center in Hamadan, 2019.

  This cross-sectional study was performed on 100 parents of children with cochlear implantation. Research units were entered into the study by census method from April to September 2018. The research instrument was demographic characteristics questionnaire and parental attitude towards the consequences of cochlear implantation questionnaire. After completing the questionnaires by the research units, the data were analyzed using SPSS software version 16 and correlation coefficient, one-way ANOVA and independent T-test at a significant level of 0.95.

parental attitude towards the consequences of cochlear implantation was significantly related to the age of the child, lasting duration of cochlear implantation, Categorization of Auditory Performance and Speech Intelligibility Rating (p<0.05).

According to the findings, the more children received higher scores in the Categorization of Auditory Performance and Speech Intelligibility Rating, the parents had more positive attitude toward cochlear implantation, and the more the age of the child and the duration of the cochlear implantation, the parental attitude towards the consequences of cochlear implantation were more positive about the implications of cochlear implantation.

Public-private partnership reduces the project fund. Besides, it focuses on utilizing private-sector capacities such as knowledge and specialized experience. The aim of this study was to match the public-private partnership models in medical education in five continents to choose a suitable model for the medical education system. Methods and Materials: This study has compared the public-private partnership models in higher education. The valid databases and websites of major universities across five continents have been searched by proper keywords of public-private partnership. The sampling of universities was done based on strategic choice, purposefulness, and access to information.

One of the good models of the partnership was to use private sector resources to train trainees in the real work environment that has benefited both public and private partners. The private sector partner had cheaper labor and the public sector partner saved money. There were furthermore, another appropriate model was consulting and knowledge transfer services for the private sector by the public sector.

It seems that using private-sector resources for clinical education as a public-private partnership in universities of medical sciences are suitable. On the other hand, the public sector lays education policy and regulation and monitors the quality and quantity of education. Correspondingly, the private sector will be responsible for providing learning space, transfer of knowledge and specialized experience.

A common complaint of dyslexic children is difficulty in understanding speech in the presence of background noise. Previous studies have suggested that the Medial Olivocochlear Bundle (MOCB) may play a role in speech hearing in noise. The MOCB function can be evaluated by the suppression effect of the Transient Evoked Otoacoustic Emissions (TEOAE) in response to Contralateral Acoustic Stimulation (CAS). The present study was conducted to investigate the suppression effect of TEOAE in dyslexic children.

The study groups comprised 32 dyslexic children aged 8–13 years with normal hearing and 32 controls matched for gender and age. The suppression effect of TEOAE was evaluated comparing the TEOAE levels with and without CAS. The dyslexic children were screened by screening inventory reading test.

There were no significant differences in TEOAE inhibition between normal and dyslexic groups. TEOAE amplitude in right ear was higher than that of left ones in dyslexic children while this finding was not observed in the normal group.

The greater amplitude of right TEOAE in dyslexic children can be due to asymmetric performance of MOCB. This pattern was not observed in normal children.

Because children learn to communicate by hearing sounds, a hearing loss (HL) will deteriorate their cognitive and speaking abilities and language learning. Early detection and intervention are important factors in the successful treatment of HL in children. HL is divided into two main groups: conductive hearing loss (CHL) and sensorineural hearing loss (SNHL); the former is more prevalent in children and many of its causes are easy to detect and treat.
In this descriptive cross-sectional study, 1,446 children, aged 11-13 years, entering first-degree high school in the school year 2016, were randomly selected from two schools in Hamadan, western Iran, and their audiograms were studied. The collected data were analyzed by descriptive statistics using SPSS 16.
Out of the 1,446 high school children examined in this study, 18 children (1.2%) suffered from HL (44.5% female and 55.5% male), 33% from CHL, and 67% from SNHL. Besides, 89% suffered from bilateral HL and 11% from unilateral HL.
Considering the prevalence of HL, especially SNHL, in this study in first-degree high school students of Hamadan, it seems vital to raise public awareness and early screening of ear diseases, which can lead to the detection and treatment in most cases.

Glomus tympanicum (GT) is a benign primary tumor of the middle ear. The evolution of endoscopic ear surgery has allowed for an alternative approach to managing this vascular tumor. The purpose of this study was to evaluate an endoscopic approach in GT surgery, and also to investigate its applicability and feasibility.
Prospectively, 13 class I and II patients, according to the Glasscock-Jackson glomus classification, were candidates for management via a transcanal endoscopic approach. Patients were categorized into three groups according to the location of the tumor in the middle ear. Group A consisted of patients with tumors located anteriorly while occupying the Eustachian tube. Group B were patients with tumors located on the promontory with entirely visible tumor borders. Patients in Group C had tumors that occupied the entire middle ear. Under specially designed flap elevation and hemostasis, the tumors were completely removed using an endoscopic technique.
Based on the classification criteria, three patients fell into Group A (30%), six into Group B (46%), and three into Group C (23%). The principal chief complaint was pulsatile tinnitus that disappeared after surgery in most cases. Hearing status was mostly mixed hearing loss. No change was detected in bone conduction after surgery, but air conduction was improved in nine cases. No major complication or recurrence was observed over 30 months of follow up.
Improved exposure and access in the endoscopic transcanal approach to GT leads to safe, rapid, and reliable tumor removal, as well as allowing comfortable surgery for both the surgeon and most patients.

Tinnitus is a distressing symptom for which few treatments exist. Low-frequency repetitive transcranial magnetic stimulation (rTMS) of the temporal cortex has been proposed as a treatment for chronic tinnitus. This study determined relationship between psychoacoustic parameters such as loudness and frequency of tinnitus and outcome with rTMS treatment.
Twenty six patients (22 male, 4 female) with chronic tinnitus received low frequency (1 Hz) rTMS at intensity 110% motor thre­shold and 1200 stimuli on three subsequent days to the left auditory cortex. The treatment out­come was assessed with loudness balance test and Tinnitus Handicap Inventory (THI).
There was a significant difference between loudness of tinnitus and THI scores before and after rTMS. There was no correlation between psychoacoustic parameters loudness and frequency of tinnitus and rTMS treatment outcome.
Our data suggest that repetitive transcranial magnetic stimulation, regardless of loudness and frequency of tinnitus, can be used as a therapeutical tool for the treatment of tinnitus.

Background and False positive in newborn hearing screening increases cost and maternal anxiety. We aimed to evaluate the effect of mode of delivery and screening age on false positive result of first screening test. Identifying and controlling these factors could reduce the rate of false positive tests. In this study, 2784 infants were evaluated by otoacoustic emissions test. The test was performed before hospital discharge. Then, the rates of false-positive were compared in infants born by vaginal delivery and cesarean section based on the screening age. False positive rate in the first screening test in neonates born through vaginal delivery was significantly higher than that of the newborns delivered by cesarean section. The rate of false positive significantly decreased with increase of screening age in infants born by cesarean delivery. Hearing screening test in neonates born through cesarean section should be conducted just prior to hospital discharge. In this way, false positive results could be reduced by about 6 times and the cost and concerns caused by the rate of false positives are also minimized.

Resilience is a positive psychological characteristic that contributes to mental health and adjustment under challenging conditions, such as deafness. Deafness is a traumatic experience and causes communication disorders; it may also affect resilience.

We compared the resilience of deaf signers to that of a matched group of hearing individuals.

This comparative study was performed to assess self-evaluated resilience in 45 deaf signers and in 76 matched hearing subjects from Hamadan, Iran. Resilience scores were measured using a modified connor-davidson resilience scale.

The average resilience score was 61.20 in deaf signers and 62.8 in hearing subjects; however, this difference was not statistically significant. The resilience score was different in female and male deaf participants. It was 65.22 for male deaf participants (SD = 10.4) and 55.17 for female deaf participants (SD = 16.1), and this difference was statistically significant (P = 0.014). The gender difference between the resilience scores of hearing participants (male, 66.24 [SD = 16.7] and female, 59.36 [SD = 13.9]) was not significant (P = 0.057).

Similar resilience scores in deaf and hearing participants may be due to appropriate interaction of deaf signers with family members and society. Male deaf subjects were more resilient than female ones; studies should be done to examine the effects of cultural characteristics that may provide females with less communication opportunities than males.

To describe the underlay tympanoplasty technique using an acellular dermal graft(AlloDerm) for tympanic membrane (TM) reconstruction in a guinea pig model and to demonstrate the feasibility of the technique using AlloDerm tissue harvested from the prepuce as a source of tissue for future grafting in human TM reconstruction. The prepuce was divided during circumcision and the acellular dermis was prepared using a number of standard processes. Two groups of guinea pigs were prepared. In the case group (20 guinea pigs and 40 ears) removal of TM was performed with tympanoplasty using AlloDerm, and in the control group (eight guinea pigs and 16 ears), removal of TM was performed without tympanoplasty. In each group, the TM was completely removed in one ear and partially removed on the other side, and the integrity of the TMs was re-evaluated after 8 weeks. In the case group, the healing rates in the completely and partially removed TMs were 83.3% and 94.4%, respectively. The difference in healing rate (0% and 66.7%, respectively) was statistically significant (P<0.05). The use of AlloDerm is safe and effective in the repair of TM perforations in a guinea pig model. Acceptable results of AlloDerm tympanoplasty in a guinea pig model may pave the way for the effective use of this material in human TM reconstructions.

Although effective strategies have been presented for preventing the spread of antibiotic resistance in Iran, recent reports have revealed increasing antibiotic resistance among children and adults.. In the present study, we tried to provide a clear view of the antibiotic resistance status of aerobic organism as the most prevalent organism in patients with rhinosinusitis in Hamadan, Iran..Patients and A cross-sectional study was conducted on 216 consecutive patients referred to otolaryngology clinics of Imam Khomeini and Besat University hospitals in Hamadan with clinical and radiological manifestations of chronic rhinosinusitis. Two specimens were taken from each patient; one from the affected maxillary sinus by aspiration and another from the middle meatus and nasopharynx by swabbing. Antibiotic susceptibility was tested by Kirby Bauer’s method; distributions of the isolates from middle meatus, nasopharynx and sinus were determined and the results of susceptibility test were analyzed.. Among the aerobic organism from meatus and oropharynx, the most frequent isolated strains were alpha-hemolytic Streptococcus (15.4%), followed by coagulase-negative Staphylococcus (14.6%), and Branhamella catarrhalis (13.2%), and the most prevalent isolated strains from sinus were S. aureus (19.1%), Klebsiella pneumonia (16.4%), and B. catarrhalis (15.6%), respectively. The highest antibiotic susceptibility was detected to ciprofloxacin and ceftriaxone in most of the strains; susceptibility to ciprofloxacin ranged from 76.7% (for Pseudomonas aeruginosa) to 100% (for Escherichia coli and Haemophilus influenza); susceptibility to ceftriaxone ranged from 71.4% (for Acinetobacter baumannii) to 100% (for S. pneumonia, Corynebacterium diphtheria, and H. influenza). Besides, regardless of strain, the highest resistance was mostly detected to penicillin (ranging from 33.3% to 91.7%), and to ampicillin (ranging from 38.4% to 83.7%).. Our study showed that resistance to some antimicrobial agents including penicillin subgroups was considerably high for managing sinusitis. Therefore, public health policies should be more focused on minimizing the misuse of these subgroups as well as limiting the inappropriate use of other agents with high susceptibility..

Tinnitus is one of the most common symptoms of patients referred to audiology clinics affecting more than 10% of the adult population. An important feature of tinnitus is its maskability which has been considered as a physiologic treatment. In this study، the role of various factors on tinnitus masking such as the loudness and frequency of tinnitus، hearing loss and the location of tinnitus has been studied. In this descriptive-analytic study، 45 patients with tinnitus، who were referred to the audiology clinic of Hamadan rehabilitation faculty، were evaluated via various audiometric tests including determination of tinnitus loudness and tinnitus frequency، minimum masking levels and residual inhibition. Maskability has been determined on the basis of residual inhibition test that used narrow band noise at 10 dB above minimum masking level for 1minute. All tests were performed with Madsen OB822 audiometer. The results showed that 46. 7% of subjects who evaluated for tinnitus had complete maskability and 35. 6% of them had partial maskability. Only 17. 6% of these patients could not be masked. The results showed that there is a relationship between tinnitus loudness and maskability. Moreover، no relation between maskability، tinnitus frequency and hearing loss were found. Results did not show any relationship between location of tinnitus and maskability. The result of this research shows that tinnitus will be masked in considerable percentage of individuals and this method can be used to control and relieve related symptoms.