Etiologic Agents of Otomycosis in the North-Western Area of Iran

BACKGROUND: Otomycosis is a superficial fungal infection often involves the pinna and external auditory canal. It is a pathologic condition, with Candida and Aspergillus, the most common fungal species. It is common worldwide but more prevalent in tropical and subtropical countries. OBJECTIVES: The aim of this study was to determine the etiologic agents and local epidemiologic pattern of otomycosis in northwest Iran. PATIENTS AND METHODS: A series of 140 patients with clinically symptomatic otomycosis were studied in 21 cities, towns, and villages throughout northwest Iran between 2009 and 2011. Clinical samples were collected by swabs and then assessed by mycological investigation. RESULTS: Otomycosis was diagnosed in 129 cases (92%, 76 male, 53 female) with the highest prevalence of cases occurring in males between 21 - 40 years of age. From an etiological point of view, 116 patients (90%, 21 - 40 years old) were infected by saprophytic mold and 9 patients (7%) were infected by yeast. Three cases (2%) involved dermatophytes, and in one case (1%) the subject was infected with Eurotium (the perfect stage of Aspergillus fumigatus). Aspergillus niger was the most common mold that was isolated, followed by A. flavus, A. fumigatus, Penicillium spp., Fusarium spp., and Rhizopus spp. A total of 2 yeasts belonging to genus Candida, C. albicans and C. tropicalis, were isolated. CONCLUSIONS: Our study showed a high prevalence of otomycosis in the northwestern area of Iran. As such, proper diagnosis and treatment by aseptic techniques for this disease is urgently needed

A case of concurrent several forms of thyroid cancer

Simultaneous occurrence of papillary and follicular thyroid cancer, known as differentiated thyroid cancer, has been reported with various presentations, but presence of an anaplastic cancer, as an undifferentiated cancer, in addition to differentiated thyroid cancer is rarely reported. We here report a 40-year-old man with papillary thyroid cancer on his right thyroid lobe and metastasized to the right posterior triangle of the neck. Survey on the mass in the right posterior triangle revealed presence of simultaneous papillary, follicular, and anaplastic thyroid cancer. The patient underwent right thyroid lobectomy and he received adjuvant radiotherapy in combination with chemotherapy. Keywords: Anaplastic, follicular, papillary, thyroid cance

Influence of glenosphere diameter and lateralization on instability of reverse shoulder arthroplasty A biomechanical investigation

Background. Prosthetic replacement of the proximal humerus with reverse shoulder arthroplasty (RSA) is an established means of treatment. Due to its unique biomechanical characteristics, RSA can restore shoulder function to a satisfying level in the case of cuff tear arthropathy, arthritis, and fractures. However, complications are frequent in RSA, one of the more common being implant instability with dislocation. The present study investigated the influence of glenosphere diameter and metaglene lateralization using a unique test setup. Methods. Seven fresh-frozen cadaveric specimens of the shoulder were thawed and dissected. The subscapularis muscle, the infraspinatus, and the three heads of the deltoid muscle were fixed to a pulley system. After implanting an RSA in different configurations (38/42 mm glenosphere with lateralization of +0mm, +5mm, or +10mm), the implants were dislocated using selective muscle pull. The frequency of dislocations depending on the prosthesis configuration was documented. Results. The larger glenosphere diameter of 42 mm showed less dislocations than the diameter of 38mm (39 vs. 46). Lateralization of +0, +5mm, and +10mm showed 26, 29, and 30, dislocations, respectively. Dislocation via pull on the infraspinatus muscle was most frequent. None of the results reached statistical significance. Conclusion. The current investigation used a novel technique for investigating the effect of lateralization and glenosphere diameter on RSA instability. Despite indicating tendencies, the present test setup could not prove the hypothesis that a larger glenosphere diameter and increased lateralization add to stability. The lack of statistical significance could be attributable to the low specimen number. The clinical significance of lateralization and glenosphere diameter should be further assessed in future biomechanical investigations

Level of Satisfaction among C o ntinuing Medical Education Participants of e - Learning Programs at Tabriz University of Medical Sciences in 2010

Introduction: Modification in medicine and medical education has led to the use of new teaching methods and learning-based tendency in education. Continuing medical education, as an indispensable part of a physician’s life, is one of the best fields of medical education that can use electronic learning. Regarding the increasing development of these programs, this study aims to examine the satisfaction of the participant with the program. Methods: This descriptive, cross-sectional study includes 50 participants. A questionnaire including questions about personal characteristics and satisfaction of the participants with the program was distributed. The gathered data was analyzed by SPSS. Reliability of scale by Cronbach’s alpha was 0.90. Results: Using Friedman test the highest score was for the clarity of educational objectives, advantage of electronic programs and satisfaction with registration method and the cost and the lowest one was that of the cost compared to classroom programs. No significant difference between men and women satisfaction level was observed (p=0.265). There was significant correlation between satisfaction and degree of study (p=0.038). Conclusion: Based on the results of the study the participant were satisfied with the program. If there is a well designed e-learning program, it will motivate the learners to be active participants