Thrita
Volume:5 Issue: 15, Mar 2016

Ovarian cancer, the third most important genital cancer and fifth cause of cancer-related death in women, is diagnosed at terminal stages in 70% of cases. Therefore, it is imperative to know the possible risk factors associated with ovarian cancer. Only a few studies have discussed the histopathological features of ovarian masses occurring after hysterectomy. The study aimed to investigate the five-year prevalence and histopathological distribution of ovarian masses after hysterectomy in Iranian patients and to determine the need for prophylactic salpingo-oophorectomy.Patients and This descriptive cross-sectional study enrolled all patients with ovarian masses and a history of hysterectomy for benign conditions who were visiting the gynecology clinic of Baqiyatallah Hospital, Tehran, between May 2009 and May 2014. Demographic information, pathological features of ovarian masses, family history, the time between hysterectomy and ovarian mass surgery, and method of hysterectomy were recorded in a predesigned checklist. The level of tumor markers such as CA125 and alpha-fetoprotein (α-FP) were measured. Of the 1052 patients with ovarian masses, 45patients (mean age, 53.11 ± 9.56 years) who had undergone abdominal hysterectomy underwent analysis. The study participants had a mean age of 47.92 ± 1.58 years at the time of hysterectomy. The mean time interval between hysterectomy and diagnosis of ovarian mass was 5.38 ± 4.15 years. Based on pathological reports, serous cystadenoma was the most frequent (43.2%) pathological diagnosis, followed by mucinous cystadenoma (17.5%). A majority of ovarian masses, especially those diagnosed within a short duration after hysterectomy, are benign. Iranian patients with such ovarian masses when asymptomatic and associated with negative tumor markers could be followed up, and prophylactic oophorectomy may not be necessary.

Coronary artery disease (CAD) or ischemic heart disease (IHD) is the most common cause of death globally. CAD is a multifactorial disease with many variable risk factors. It is estimated that its prevalence is increasing in various populations. CAD in young adults is also increasing in Iran due to the life style changes. Identifying risk factors and timely correction can reduce the burden of disease and related health problems. To evaluate the prevalence of CAD and the traditional risk factors according to angiographic findings of patient’s ≤ 50 and > 50 years old.Patients and This is a cross sectional descriptive study on 112 patients who were admitted to Boo-Ali hospital from November 2013 to December 2014 for evaluation of CAD. Self-administered questionnaire consisted of demographic data and risk factors were filled. Angiographic film was reviewed in respect to coronary arteries involvement and echocardiography was performed. For evaluation of left ventricular (LV) function, patients divided into two groups of ages ≤ 50 (group A) and > 50 (group B) years old. Risk factors, coronary angiography and ejection fraction (EF) were compared. Of the 112 patients, 51 (45.5%) were in group A and 61 (54.5%) were in group B with mean age of 37.6 ± 4.4 and 63 ± 8.5, respectively. No significant statistical differences were found between the body mass index (BMI), smoking, family history (FH), hyperlipidemia (HLP) and diabetes mellitus type 2 (DM2) between two groups (P > 0.05). Hypertension (HTN) was significantly higher in group B vs. group A respect to 65.6% and 31.4% (P < 0.001). Left circumflex artery (LCX) involvement were 54.9% in group A vs. 54.1% in group B, right coronary artery (RCA) involvement were 54.9% in group A vs. 54.1% in group B and left coronary artery (LAD) involvement were 54.9% in group A vs. 54.1% in group B. There were no statistical significant differences in coronary arteries involvement and the number of vessels disease between two groups (P > 0.05). There were a significant higher number of patients with a decline in EF in group B (P = 0.01). The pattern and number of vessels involved were similar in both groups. Based on common prevalence of traditional risk factors among two groups, planning for lifestyle changes is recommended.

Trichotillomania (TTM) is a type of chronicimpulse control disorder characterized by the recurrent pulling of hair, which can cause pleasure, relief of pressure and can be associated with infections or skin diseases in the hair pulling areas. A 4.5-year-old girl without any psychiatric disorders in the family. She was cared for by her mother, and the child had a history of separation anxiety. After detection of trichotillomania, her head was shaved by her parents in order to avoid pulling of the hair, but triggered additional psychiatric problems and isolation. Trichotillomania usually can be seen in children aged 10 to 13 years but in this case occurred at the young age of 4.5 years. Trichotillomania may also be seen in preschool-aged children and may be associated with separation anxiety disorder. Improper and late treatment can be associated with a worsening of the disorder.

Otitis media with effusion (OME) is one of the main sources of hearing impairment in children. One of the possible causes of middle ear infection and OME is immune system disorders. Based on previous studies, vitamin D deficiency plays an important role in the incidence of middle ear infections. This study aimed to determine blood levels of vitamin D in children with OME (as an inflammation of the middle ear) in comparison to a control group of patients admitted to Loghman-Hakim hospital in Tehran.Patients and In this case-control study, one hundred twenty children with OME who were admitted to Loghman-Hakim hospital between April 2013 and March 2014 and who were candidates for adenotonsillectomy were studied. They were divided into two groups based on tympanometry. The first group contained patients with OME and hearing loss of Type B or Type C2, and the second group (control) contained patients without OME and tympanometry of Type A or Type C2. On the day of surgery, blood samples were obtained for measurement and comparing of serum levels of vitamin D in the two groups. In this study, 120 children (40 cases and 80 controls) that were candidates for tonsillectomy were studied. The largest number of cases was males (60%). The mean age of patients with otitis media was 5.7 ± 2.6 years-old and in the control group was 7.2 ± 2.2 years-old. The mean levels of vitamin D in children with OME was 26.1 ± 14.6 ng/mL and in children in the control group was 29.5 ± 17.9 ng/mL (P = 0.27). Although there was not a significant relation shown between vitamin D levels between the two groups in our study, the vitamin D level in OME patients was less than in the control group. Therefore, it seems that measuring the level of vitamin D in these patients is necessary, and a deficiency of vitamin D must be treated. In order to achieve certain results with more detail we suggest more studies with larger sample sizes and covering a longer time period are needed on this topic.

Tonsillectomy is associated with early and late postoperative complications in the children. Previous studies have shown some effects of dexamethasone; however, there has been a lack of studies that evaluate its effects on other complications, including odynophagia and otalgia. We aimed to investigate the effects of dexamethasone on odynophagia and otalgia after surgery.Patients and In this randomized clinical trial, 100 patients who underwent adenotonsillectomy were divided into two groups: one group received 0.1 mg/kg of dexamethasone (case) and the other received Ringer serum as a placebo (control). Intravenous (IV) dexamethasone was prescribed to be administered by a nurse on the ward. The incidence of bleeding, nausea and vomiting, odynophagia, voice change, acetaminophen intake, halitosis and otalgia, and activity were evaluated at 24 h and during the first 7 days after surgery. The mean ages of patients were 7.1 ± 2.8 and 6.5 ± 2.4 years in the control and case groups, respectively. The overall proportions of females and males were 41% and 59%, respectively. No significant difference in demographic data was seen between the two groups (P > 0.05). There was a significant difference in terms of odynophagia and nausea and vomiting between the case and control groups after 24 h (P = 0.001). There was no significant difference between the case and control groups in terms of bleeding, voice change, halitosis, or nausea and vomiting after 7 days (P > 0.05). Meanwhile, there were a significant difference in the incidence of acetaminophen intake (60% vs. 30%, P = 0.002), odynophagia (24% vs. 6%, P = 0.011), otalgia (20% vs. 4%, P = 0.014), and activity (80% vs. 98%, P = 0.004) of patients after 7 days between the groups. In children undergoing adenotonsillectomy, dexamethasone has a significant antiemetic effect and decreases odynophagia, otalgia, and the need for analgesia.

Facial nerve neuroma is a rare disease that comprises less than 1% of all intrapetrous mass lesions. Diagnosis of the lesions of the tumor is difficult, as these tumors have relationships with other structures of the lateral skull base, such as nerves. In addition, surgical treatment is difficult because the risk of injury after the intervention is high. In this case report, we describe the clinical findings, diagnosis, and treatment of a 55-year-old man with facial nerve neuroma in the mastoid portion, a rare type of neuroma who underwent surgical operation at Khalili Hospital, Shiraz, Iran. In this report, we describe a rare facial nerve neuroma in the mastoid portion in a 55-year-old man with a history of hypertension (HTN) and diabetes mellitus (DM). The patient also had otalgia related to the periauricular area, otorrhea, and tympanic membrane retraction on the left side. In addition, the patient had facial palsy (Brackmann grade V) and often suffered from headaches. Magnetic resonance imaging (MRI) with contrast, biopsy from the external ear canal region, and tympanometry were carried out. Then, the patient underwent surgical treatment, and the mass was successfully totally removed. The result of the patient’s pathology test was margin free. At a recent follow-up, the patient was still symptom-free (otalgia and headache). In surgery for facial nerve neuroma in the mastoid segment, it is better not to rely on imaging alone; all facial nerves from the geniculate ganglion to the styloid foramen become exposed for tumor removal.

Immunosuppressive tacrolimus is widely used in liver transplantation but could be potentially neurotoxic if blood levels increase to more than 15 mg/L. The aim of this study was to investigate the drug levels that might be related to the neurotoxic effects of tacrolimus.Patients and Based on a cross-sectional method, preliminary data was obtained from fifty patients after liver transplantation. To determine the effectiveness or side effects, evidence-based results were obtained using Prograf therapy. Further data was obtained by reviewing the patients’ medical records. Trough levels of tacrolimus were determined by microparticle enzyme immunoassay. Statistical analysis was performed using SPSS. There was no correlation between the dose and the trough level in the population (n = 45) studied (P = 0.270, r = 0.168). In 80% of patients, the tacrolimus dose was 5 mg and trough levels of tacrolimus showed as highly variable. The mean trough level was 13.2 mg/L (range: 0.1 - 41.4 mg/L). In 35% of patients, the level of tacrolimus C0 was more than 15 mg/L, which appeared to indicate a neurotoxic side effect. In the Iranian population of organ transplantation polypharmacy should be based on a rational basis of scheduled therapeutic drug monitoring. To confirm the presence of a correlation between Prograf levels with early or late rejection, nephrotoxicity or neurotoxicity, further studies in a greater number of liver recipients are recommended.