Comparative Evaluation of Melatonin as an Alternative Therapy in Tinnitus: A Double-Blind, Placebo-Controlled Randomized Trial

Background: Tinnitus is an auditory perception that is described as a perception of noise without any external acoustic stimulant. Tinnitus causes many problems including sleep disturbances and difficulty in concentrating for patients. Aim: In this trial, we evaluated melatonin as an alternative therapy in tinnitus. Methods: In this clinical trial, tinnitus patients (n = 90) were randomly assigned to 12 weeks of double-blind treatment with melatonin (n = 30) at a fixed-dose (3 mg once daily), sertraline (n = 30) at a fixed dose (50 mg once daily) and placebo (n = 30) once daily. The treatment outcomes were measured using THI (Tinnitus Handicap Inventory), tinnitus loudness score, and tinnitus awareness score after 3 months. Results: The baseline assessment with THI (Tinnitus Handicap Inventory) showed no significant difference in THI score between groups before treatment (p-value = 0.38). The mean THI score shows a significant decrease in both melatonin and sertraline groups (p-value < 0.03). Overall, a mean of 20% decrease in tinnitus loudness score and a 2-fold decrease in tinnitus awareness score was seen in the melatonin group. In contrast, a mean of 2% decrease in tinnitus loudness score and 25% decrease in tinnitus awareness score was seen in the sertraline group. Conclusion: Both melatonin and sertraline reduce tinnitus loudness score and tinnitus awareness score within 12 weeks in primary care, but melatonin showed a more significant outcome. Our findings support the prescription of melatonin in tinnitus management

The Protective Role of Zinc Sulfate in Temporary Noise-induced Threshold Shift: a Randomized Clinical Trial Study

Background: Exposure to excessive sound leads to hearing loss. Temporary threshold shifts are defined as threshold shifts that return to baseline levels in the hours to weeks after excessive sound exposure. Aim: This study aimed to examine the zinc sulfate protective effect following noise exposure. Methods: Fifty-two participants with normal audiograms at baseline were randomly assigned to control and intervention groups. First, a distortion product otoacoustic emission test (DPOAEs) was carried out as the baseline assessment, then the intervention group received zinc sulfate supplement capsules for one month and placebo capsules were given to controls. To induce a transient hearing shift, an ABR test was performed. The ABR test was done with 90 dB of sound stimuli for each ear. This input stimulus was a noise exposure that induces a temporary reduction in hearing, in fact, a transient hearing shift has occurred. Then, both groups had a DPOAE test and a follow-up assessment. Signal/noise ratio and DP (distortion product) levels were measured to evaluate the effect of zinc supplement use on transient hearing shift. Results: Comparing the results of the distortion product otoacoustic emission test before and after the auditory brainstem response testing showed significant differences between intervention and control groups (p <0.05). Moreover, the differences in signal/noise ratio between the intervention group before and after ABR testing and also in the control group were significant (p <0.05). Conclusion: Daily zinc sulfate supplement might protect against the transient hearing shift

Prevalence of micro-aspiration of bile acids in patients with primary lung cancer: A cross-sectional study

BACKGROUND: Lung cancer remains a serious public healthproblem and is the first cause of cancer-related death worldwide. There is some evidence suggests that bile acid micro-aspiration may contribute to the development of lung diseases. This study aimed to assess the prevalence of microaspiration of bile acids in patients with primary lung cancer.METHODS: In a cross-sectional study, 52 patients with primary lung cancer referred to a teaching hospital affiliated with Kerman University of Medical Sciences, Kerman, Iran were enrolled. Patients with pathology-confirmed lung cancer who did not receive specific treatment were included in the present study. All patients underwent bronchoscopy and the levels of bile acid was assessed in their Broncho-Alveolar Lavage (BAL) samples.RESULTS: According to the results, 53.85% of patients were in the age group of 40 to 59 years. Of the participants, 88.46% were male, 82.69% were smokers, and 69.23% were opium addicted. The most common presenting clinical symptoms of patients were heartburn (61.55%), hoarseness (17.31%), and epigastric pain (9.61%), respectively. Ninety-two point thirty two percent of patients had endobronchial lesions in bronchoscopy. Squamous cell carcinoma, small-cell lung carcinoma and adenocarcinoma accounts for 48.08%, 34.61% and 17.31% of all cases of lung cancer, respectively. Bile acids were found in the BAL sample of all patients with primary lung cancer. The mean Bile acids levels in patients were 63.42 (SD=7.03) μmol/Lit.CONCLUSION: According to the results of present study, there was a micro-aspiration of bile acids in all patients with primary lung cancer that may participate in shaping early events in the etiology of primary lung cancer. It seems that developing clinical strategies preventing the micro-aspiration of bile acids into the lungs could remove a key potential trigger in this process

Sudden sensorineural hearing loss after receiving an inactivated viral vaccine, Sinopharm: Two-case report

The prevalence of Coronavirus Disease 2019 is a global threat. Due to the high mortality rate caused by this disease, the vaccination is mandatory to protect patients against it and reduce the mortality. Rapid development and widespread use of vaccines have raised the possibility of adverse side effects over the course of administration and follow-up. In this study, we investigated an adverse event of sudden sensorineural hearing loss in two patients receiving first dose of Sinopharm, an inactivated viral vaccine. Both patients experienced sudden hearing loss in their left ear some days after receiving the first dose of the Sinopharm and had normal otoscopic examinations in both ears and mild to severe sensorineural hearing loss was reported in the left ear. After imaging evaluation with magnetic resonance imaging which showed no pathologic points. Two patients were treated with prednisolone and valacyclovir. Both patients experienced response and had good prognosis in their follow-up. Our study showed that there is no direct evidence of an association between Coronavirus Disease 2019 vaccination. A viral infection can cause sudden sensorineural hearing loss and should be considered as a possible side effect after vaccination. Although the number of side effects reported in clinical trials has been very low, long-term follow-up of patients is needed to assess the vaccine’s safety, given the incidence of these cases

Enhancement the skin flap survival in mice applying topical and systemic atorvastatine:a randomized clinical trial study

Introduction: Skin flaps play a valuable role in reconstructive surgeries⋅ However, ischemia and necrosis of random designed flaps are still a challenging entity. Our objective was to investigate the feasibility of atorvastatin applied in topical and systemic form to improve the skin flap survival in mice. Materials and method: One hundred adult male mice of the same strain were randomly divided into four main groups. After anesthesia and prophylactic antibiotic injection, random dorsal skin flaps were designed based on the modified McFarlane's method. In the first main group (control group) which contains two subgroups saline was administered intraperitonealy and topically respectively. In the second main group (vehicle group) carboxymethyl cellulose(vehicle solution) was administered intraperitonealy in one subgroup and vaseline applied topically in the other subgroup. In the third main groups (included three subgroups) 1, 5, and 10mgr/kg of body weight atorvastatin dissolved in carboxymethyl cellulose applied intraperitonealy for two weeks. In the fourth group (included three subgroups) atorvastatin ointment 1%, 5%, and 10% was applied topically for 14 days. After 2 weeks flap necrotized surface investigated using digital photography. Results: Atorvastatin in Systemic and topical form could decrease the necrotic surface of the random designed skin flap. However, systemic application of atorvastatin seems to be more effective than topical administration, No statistically significant difference was observed between low dose atorvastatin (1 and 5 mg/kg)

The stage of head and neck diagnosed malignancies in COVID‐19 outbreak versus before outbreak: A retrospective study

Abstract Background Global COVID‐19 pandemic has affected cancer care systems. Recent studies show that the number of cases diagnosed with cancer has drastically decreased compared to the same period before the pandemic. Therefore, we are confronted with delayed diagnosis of critical cancers. Aim The aim of this study is to investigate whether the stage of known cancers has been affected by delayed diagnosis and to compare the stages of head and neck cancers diagnosed during and before the pandemic. Methods The present study was conducted on 132 patients with malignant head and neck tumors referred to the otolaryngology, head and neck cancer department of Taleghani Hospital from 2019 to 2021. The stage of cancers was compared between two groups of patients with head and neck malignancy referred to the Otolaryngology, Head and Neck Department of the Taleghani Hospital before and during the COVID‐19 outbreak. Results The results from tumor (T), nodes (N), and metastases (M) (TNM) staging (p‐value = .015) and T score (value = 0.045) showed that the stage of tumor diagnosed in patients during the COVID‐19 pandemic significantly increased compared to patients diagnosed with a tumor before pandemic. Conclusion In the present study, it was observed that the early symptoms of malignant head and neck tumors have been neglected by patients during COVID‐19 pandemic and resulted in delayed diagnosis. This result may be explained by the fear of COVID‐19 infection in patients, which discouraged them from visiting a doctor at healthcare centers

Schwannoma (neurilemmoma) of tongue: A rare case presentation and review of literature

Key Clinical Message It seems that schwannomas of the tongue base originate from branches of the glossopharyngeal, vagus, or hypoglossal nerves. Additionally, complete trans‐oral surgical excision is an efficient method to remove them