Journal of Kerman University of Medical Sciences
Volume:30 Issue: 5, Sep-Oct 2023

External dacryocystorhinostomy (DCR) failure is sometimes due to pathologies located within the nasal cavity. Preoperative computerized tomography (CT) scan is useful in the assessment of nasolacrimal drainage and adjacent anatomical structures; however, it is not routinely performed before DCR. The present study evaluates abnormal findings in CT scans of patients with nasolacrimal duct obstruction (NLDO) and its effect on changing treatment approaches.

This prospective descriptive cross-sectional study included 162 patients with NLDO. All the patients underwent a supine axial CT scan. Patients with signs of rhinosinusitis, sinus mucositis, nasal septal deviation, nasal polyps or masses, and turbinate deformities were referred to an otolaryngologist. The rest of the patients underwent external DCR. The demographics and radiologic characteristics of the patients undergoing CT scans and their effect on changing treatment approaches were evaluated.

The study participants included 162 patients with a mean±SD age of 62.5±14.0 years (age range of 35-93 years). The percentage of endonasal DCR in cases with an abnormal nasal cavity on CT scan was almost 30% higher compared to those without this problem (59.6% vs. 30.2%). Septum deviation and turbinate deformity led to 3.6-fold and 3.9-fold changes in the surgical approach, respectively.

A significant association existed between the sinonasal pathologies in patients with NLDO and changing surgical approaches. It is believed that a preoperative CT scan is necessary to detect such pathologies and manage them appropriately.

Systemic or topical form of pentavalent antimony compounds such as Meglumine Antimoniate (MA) are used as Standard treatment for cutaneous leishmaniasis (CL). However an increasing number of studies demonstrate evidence of treatment failure with said drugs. The objective of this study was to determine the factors associated with systemic MA treatment failure in patients with acute cutaneous leishmaniasis. In this case-control study, patients with urban CL who were referred to leishmaniasis clinics in Mashhad from 2017 to 2018 were followed up 12 months after the start of treatment and were evaluated for improvement or failure according to the national leishmaniasis protocol. 112 cases of CL, 59 men and 53 women with a mean age of 23.3 ± 21.11 years were studied. The number of patients with clinical improvement was significantly higher in women (P = 0.005). Also age, BMI, occupation and education, the possible infection and living location, past medical, drug and leishmaniasis recurrence history, lesion’s characteristics, ulceration were also significantly different between the two groups of improved and unhealed patients. The results of this study showed that the male sex, age less than 18 years, receiving pentostam, previous treatment history, lymphadenopathy, urban leishmaniasis, duration of illness more than 4 months, having a single lesion especially on the face, BMI less than 18 and a lesion size of more than 3 cm is more common in patients with treatment failure.

Substance abuse in women has an increasing trend in all socio-economic classes. In addition to the fetal consequences, this problem has many other economic and social consequences as well.This study aimed to determine the prevalence of substance abuse and its related factors in pregnant women.

This descriptive cross-sectional study was performed employing a self-administered valid questionnaire on 587 pregnant women in Kerman, Iran who referred to public health centers and private offices to receive prenatal care. Participants were recruited from January to February 2020 using a multistage sampling method.

The most prevalent substances used during pregnancy (current use) were waterpipe (8.5%), opium (2.6%), and alcohol (1.7%).Substance abuse in first-degree relatives was a very strong correlate of substance abuse in pregnant women (OR = 7.26). The low level of education of pregnant women's husbands was also a strong predictor of substance abuse in pregnant women. (OR = 3.15).

Since substance abuse by family members was the strongest correlate of drug abuse during pregnancy, family-based interventions should be tailored to address early detection of such vulnerable women and necessary counseling services.

Epilepsy is one of the most common disorders of central nervous system. A lot of factors affect the occurrence and severity of Epileptic Attacks (EAs). Food is one of the most challenging of the factors. Fasting during Ramadan is one of the important requirement in Islam and it has always been challenging for the epileptic patients. This study evaluated the number of admitted cases to Emergency Room (ER) by epileptic Attacks patients during Ramadan.

This prospective and cross sectional study evaluated all ER visits during the months of Shaaban, Ramadan, and Shavval by EAs (all were convulsions). In this study, the mean average of ER visits frequency was compared between the three months. The differences were significant P<0.05, between the mean average of EAs.

From the 156 cases, half were male and half were female. Frequency of EAs were 68, 35 and 53 for the months of Shaaban, Ramadan and Shavval respectively. It was noticed that there were about 40% reduction in ER visits during the month of Ramadan, mainly due to discontinuance of antiepileptic drugs.

During the Holy month of Ramadan, the number of visits to the ER due to EA (convulsions) decreased. Two mechanisms are involved for the reduced number of epileptic discharges and control of their occurrence: consumption of high fat diet and bigger protein portions, plus reduced food consumption. Other factors can be reduced travel during Ramadan, better administration of drug, and the peaceful psyche attributed to this month.

lysyl oxidase (LOX) and magnesium contribute to vascular development and stability. So, this research describes the therapeutic role of magnesium sulfate (MgSO4) in patient with moderate coronary artery disease (CAD) through regulating the serum levels of LOX and nitric oxide. A randomized double blind placebo-controlled clinical trial with 76 moderate CAD patients divided into four groups. They randomized to use of capsules containing placebo or MgSO4 (300mg) daily during 6 months. So experiments are designed to include Mg-treated- groups with 1and 2 atherosclerotic plaque (Mg-VR1, and Mg -VR2) and placebo-treated- participants with 1 and 2 atherosclerotic plaque (placebo -VR1, placebo -VR2). Every 3 months, LOX, homocysteine, nitrite, and lipid profiles levels were measured. The women and men with moderate CAD who had age of more than 55 and 50 years respectively were included. Total cholesterol and TG (triglycerides) was significantly decreased 6 months after intervention (p<0. 01). Decrease of serum homocysteine level was seen in all groups during the study but the reduction in placebo groups were more than Mg- treated groups (p<0.001). 3months after treatment with MgSO4, LOX was maintained in high levels and returns to base line at 6 months follow up (p<0.001). The rise of nitrite level in placebo -VR2 groups was significantly greater than Mgso4-VR2 treatment (p<0.001). magnesium sulfate may prevent the progression of arteriosclerosis through modulating LOX and homocysteine level and prevent increasing of nitrite level. This randomized study has been approved by Iranian Registry of Clinical Trials with IRCT20151028024756N3 code

Due to the high load of COVID-19 pandemic and its extraordinary mortality rate and some antiviral effects of cactus compounds in the literature, the present study seeks the notion of assessing the effect of Cactus Opuntia in patients with COVID-19 infection considering signs and symptoms of relief.

Methods & Materials:

 It was a randomized controlled trial. Patients with COVID-19 infection referred to Imam Ali hospital located at Karaj, randomly divided into intervention and control groups. All patients received a standard treatment regimen based on the latest guidelines. Patients in the intervention group received 250 mL Cactus Opuntia extract syrup daily in addition to standard treatment and the control group received only the standard regimen. Patients’ symptoms including coughing, dyspnea, myalgia, headache, weakness etc. were evaluated daily and compared between the two groups.

Fifty-two patients participated in the study. Mean length of hospital stay, duration of blood oxygen saturation below 93, fever, anosmia, coughing, headache, dizziness, myalgia, dyspnea, chest pain and anorexia were significantly shorter in the intervention group compared to the control group (p<0.05).

Cactus Opuntia extract led to symptomatic improvement of COVID-19 patients by reducing the length of hospitalization and the duration of most signs and symptoms compared to the control group. Further confirmatory studies are needed to affirm these findings.

Distal polyneuropathy is a common complication of diabetes mellitus with a considerable negative impact on the quality of life. The aim of this study was to evaluate the effect of dry cupping on distal polyneuropathy in diabetic patients. This controlled clinical trial was performed on 34 patients with diabetic polyneuropathy (DPN) for eight weeks. The non-invasive dry and fixed cupping therapy was performed on the sole of the right foot in the patients three times a week for 10 min, and the left foot of the same patient was considered as a control. The severity of diabetic neuropathy was measured using the modified Toronto Clinical Neuropathy Score (mTCNS), and the symptom and sensory test scores were determined. 20 patients (40 feet) completed the study. There was a significant difference between the control foot and the treated foot in terms of the mTCNS after four and eight weeks (p-values = 0.004 and 0.001, respectively), in terms of the sensory test scores after four and eight weeks (p-values = 0.007 and 0.005, respectively), and in terms of the symptom scores after eight weeks (p-value = 0.002). For the first time, this study demonstrated that cupping therapy might be effective as a complementary treatment in alleviating the symptoms of DPN, although understanding the underlying mechanism requires further investigation.

Oral lichen planus (OLP) is a chronic inflammatory disease that affects 0.1% to 4% of the population. The disease causes lesions in the buccal mucosa, gingiva, and rarely in the palate. In this study, the relationship between OLP and TNFα-308 G / A and IFN-γ + 874A / T polymorphisms was investigated. In this case-control study, a sample of buccal mucosa was taken from 50 healthy individuals and 50 OLP patients referred to Kerman Faculty of Dentistry were included by easy sampling method. Then, the presence of TNFα-308 G / A and IFN-γ + 874A / T polymorphisms in the case and control groups was determined using ARM-PCR technique followed by sequencing. Frequency of allele A and GA of TNF-α (-308G / A) gene was significantly higher than G and GG in OLP patients compared to control group (P-value <0.0001). Also, AA genotype of TNF-α (-308G / A) gene was not present in OLP patients. About IFN-γ + 874A / T polymorphism, the association between T allele and the risk of oral lichen planus was confirmed but it was not statistically significant (p-value: 0.068). There is a strong association between the A allele of TNF-α (-308G / A) and the risk of developing oral lichen planus, although this association between the IFN-γ + 874A / T genotype and Oral lichen planus was also confirmed, but it was not strong enough to be used to predict the likelihood of developing the disease.

Sodium-glucose co-transporter-2 (SGLT-2) inhibitors are a relatively novel class of oral medications for the treatment of Type 2 DM with a generally acceptable safety profile. Euglycemic DKA is a diagnostic challenge for physicians due to the variety of etiologies and normal blood glucose levels, often resulting in delayed diagnosis. Euglycemic ketoacidosis is a rare but rather serious complication of SGLT-2 inhibitors use, often with a multifactorial etiology. Its atypical presentation requires a high level of awareness by physicians as early recognition of this complication can quickly and safely restore acid-base balance. EuDKA is not identical with the typical diabetic ketoacidosis, as it often presents with serious metabolic acidosis but only mild to moderate glucose and anion gap elevation. Patients with type 1 or type 2 diabetes who experienced nausea, vomiting, malaise, or develop metabolic acidosis in the setting of SGLT-2 inhibitor therapy should be promptly evaluated for the presence of urine and/or serum ketones.

The Covid-19 disease was first observed in December 2019 and became a big challenge for the World Health Organization in a short period of time. Getting infected with Covid-19 has very dangerous complications and is considered a serious threat to people's health. One of the most important ways to prevent this disease is vaccination. Like other vaccines, the Covid-19 vaccines also have various side effects, The side effects of existing vaccines are usually mild and transient, and the side effects related to hearing are very rare.

Case report: 

In this study, we have presented a report of a 40-year-old woman with a complaint of tinnitus 24 hours after the injection of the second dose of Sinopharm vaccine. The patient did not have any history of hearing problems or tinnitus before the vaccine injection. According to the results of the evaluations, the necessary counseling regarding tinnitus, sound therapy and counseling sessions were provided to reduce the patient's anxiety. After one month, the patient was very satisfied with the cessation of tinnitus.

tinnitus without hearing loss is reported as a rare side effect of vaccination. Since the exact mechanism of tinnitus after vaccination is not fully clear yet, there is a need for more studies in this field.