مجله دانشکده پزشکی اصفهان
پیاپی 566 (هفته دوم اردیبهشت 1399)

Chronic renal failure refers to an irreversible deterioration of renal function that follows a progressive course and ultimately leads to necessity of dialysis in most of patients. As some studies have indicated that the mentioned patients may eventually develop lipid profile abnormalities, the present study aimed to evaluate the effective factors in lipid profile changes in these patients over one year.

In this cross-sectional study, 251 patients under peritoneal dialysis, whose profiles were available in the archives of Alzahra hospital, Isfahan, Iran, during 2018-2019, were randomly selected. Demographic data and lipid profile of these patients including total cholesterol (TCH), low-density lipoprotein (LDL), high-density lipoprotein (HDL), triglyceride (TG), and blood glucose levels were recorded and analyzed at baseline as well as six months and one year after the start of dialysis.

Changes in the lipid profile of the patients during one year of dialysis were significant (P < 0.050). Sexuality had a direct and significant relationship with all the changes in lipid profile items (P < 0.001). In addition, as well as an increase in the hemoglobin (Hb) level, it had a direct and significant relationship with elevated levels of LDL, TCH, and TG (P < 0.001 for all). Moreover, blood glucose level had a significant relationship with increased levels of TCH (P = 0.040) and TG (P = 0.014). Finally, dialysis solution with 2.5% and 4.25% dextrose had a significant and direct effect on increasing the levels of TCH (P =0.035) and LDL (P = 040), respectively.

According to the results of the present study, the lipid profiles of patients undergoing peritoneal dialysis revealed significant changes. The most significant factors associated with lipid profiles were the type of dialysis solution, and the levels of blood glucose and Hb.

Failure to maintain airway after induction of general anesthesia or in patients with multiple trauma who need airway resuscitation or oxygen delivery is one of the most common causes of mortality and disability. Therefore, in this study we aimed to investigate the association between the neck circumference and the distance between the outer ear canal and the upper edge of the manubrium compared to Cormack-Lehane score in patients undergoing laryngoscopy.

In this cross-sectional study, the neck circumferential of patients was determined by the location of the thyroid gland in centimeters and the distance between the outer ear canal and the upper edge of the manubrium was determined and divided by the circumference of the neck to achieve the index. In the next step, using the score of Cormack-Lehane, the grading of larynx was assessed and compared with the index.

18 patients (15.65%) had severe laryngoscopy and 97 (84.35%) had easy laryngoscopy. The area under the receiver operating characteristic (ROC) diagram was between 0.5 and 0.6 which was less than 0.6 and indicated that the studied index was not a suitable criterion for assessment of the difficulty of laryngoscopy and was not different from random selection (P = 0.255).

Taken together, the results of our study showed that the ratio of the peripheral neck circumference to distance between the outer canal and manubrium could not be used as a suitable alternative to the Cormack-Lehane score for prediction of difficult intubation.

Tinea incognito is a fungal infection with bizarre presentation due to the topical use of steroids or calcineurin inhibitors. Herein, we present a case of tinea incognito infection.

A 9-year-old girl complaining of pruritic non-scaly erythematous papulopustular lesions and a 3-month history of use of clobetasol propionate 0.05% referred to our dermatology clinic. In the examination, papules, erythematous plaques, and pustules were found diffusely on her face, neck, arm, and dorsum of the hand. The smear and culture of the lesions confirmed the diagnosis of tinea incognito. The patient was treated completely with fluconazole capsules, ketoconazole shampoo, and clotrimazole cream.

Due to widespread and improper use of steroids, the incidence of tinea incognito infection has increased. Oral antifungals can be used safely and effectively in treatment of these patients.