Case Report Congenital Intralabyrinthine Cholesteatoma

A patient with a congenital intralabyrinthine cholesteatoma is presented. High-resolution computerized tomographic scans and intraoperative photomicrographs display features of intralabyrinthine extension. We discuss pathogenetic theories for the development of congenital intralabyrinthine cholesteatoma. The distinction of this condition from congenital cholesteatoma with labyrinthine erosion is discussed

Clinical Tools to diagnose Eustachian tube Dysfunction in patients with a normal tympanic membrane exam and a type A tympanogram

Objective: Obstructive Eustachian tube dysfunction, a form of Eustachian tube dilatory dysfunction, can be a challenge to diagnose in individuals with classic Eustachian tube dysfunction symptoms but a normal tympanic membrane exam and tympanogram. The purpose of this article is to outline techniques that can be used by the otolaryngologist to evaluate patient’s under these circumstances.Methods: Eustachian tube dysfunction was assessed combining fi ndings from dynamic evaluation of the tympanic membrane with videoendoscopic evaluation of the Eustachian tube. The “Azadarmaki technique” of assessing the tympanic membrane for eustachian tube dysfunction involves evaluating the tympanic membrane live with a microscope or endoscope while the patient is performing the Valsalva maneuver followed by an immediate swallow.</p

The Process of Patient's Privacy: A Grounded Theory

Introduction: Ethics, customs, and divine and human values in all scientific and non-academic issues are accepted among all human societies in different eras. The purpose of this study was to understand the experiences of nursing professionals about the patient's privacy. Methods: 21 participants were selected by theoretical sampling which was guided by emerging categories. All participants were interviewed individually. Subjects were interviewed in a private setting and transcription was done after each interview. In-depth interviews and semi-structured questions were used for data collection. Corbin and Strauss’ Ground theory methodology was applied in order to explain the process of patient's privacy. Data analysis was an ongoing process which was started during data collection. Data analysis method included a three-step coding process including open coding, axial and selective coding through repeated line by line reading of transcripts. Results: Four central categories were identified from transcripts' constant comparative analysis: weakness of system, actors with serious effort, trying to maintain privacy and tension creation. Conclusion: Familiarity with how nurses deal with patient’s privacy can improve professional development, client satisfaction and observation of their rights. Nurses with sensitivity to patient’s privacy can manage their expectations respectfully

Institutional configurations and trust in religious institutions in Muslim societies

Islamabad, Pakista

Gender and Religiosity

Introduction The role of religion and its influence on different aspects of social life has always been under the attention of sociologists of religion but gender differences, its reasons and factors, have often been overlooked. Even research on this subject sometimes leads to inconsistent results. Generally, such research shows that women outdo men in prayers, religious activities and religious beliefs. There are so many different opinions about the reasons of such differences. Some attribute it to position structure, some to gender orientations and gender socialization, some to personal differences and some to the theory of risk aversion. Therefore, given the importance of the subject, little available research about it, and different, sometimes contradictory findings, it is essential to study the role of gender in religiosity, addressing questions such as: are women and men equally religious in our society? Are there any differences between women and men in terms of religiosity? Does research on different religions confirm these findings? Can power structure in family explains women’s greater religiosity? The present study attempts to answer these questions. Despite different research that shows women outdo men in prayers, religious activities and religious beliefs, Lowenthal believes that these differences depend on the culture and tradition of each religion. He states that any religion differentiates between religious obligations of men and women. Islam and Judaism, for example, place less strenuous duties upon women than upon men. In Judaism, women are not required to pray with a congregation and in Islam women should not enter mosques during their menstruation. Therefore, women are expected to pay less attention to the place of worship and to take part in some religious activities less often than men. In Christianity and Hinduism, in contrast, women are more religiously active than men. Hindu women are more willing to go to temples and probably Muslim and Jewish men do more religious activity than women and this is in contrast to Christians and Hindus. Loewenthal suggests that such differences lead us to expect different gender effects between Christians, Muslims and Jews. He concludes that although women are more religious than men, they do less religious activities than men do. In Christianity, women are more religious than men. In Hinduism, Islam and Judaism, men are more religious than women. Lowenthal attributes such differences to traditions and cultural norms of religions, whereby he negates this general principle that women are more religious than men (Loewenthal, 2001). To justify reasons of such differences, Miller and Stark believe that such gender differences have a physiological origin, resulting from risk priority. They suggest that men show more risky behaviors because of their risk priority and women are more religious due to their physiological nature of risk aversion. Extending the control-power theory of Hagan and colleagues and accepting risk-priority theory of Miller and Stark, Collet believes that these differences have a social origin, whereby gender differences in religiosity is linked to power structure of family and is thus explained. He states that boys in patriarchal families are encouraged to show more risky behaviors and girls are restricted to do so. Such gender differences seem to be lesser in egalitarian families. According to this theory, patriarchal or egalitarian families, by showing different behaviors, cause different gender socializations in children, which continue until adulthood. Since girls in patriarchal families are controlled more than girls in egalitarian families, they show risk aversion more and therefore are more religious. In view of the theoretical approaches of this research, which are based on the opinions of Loewenthal and Collet, we examine the following assumptions: women are more religious than men; religiosity is not equal in different religions; women living in patriarchal families adhere to religious values and are more religious. Materials & Methods The present study is a national survey research which has been carried out by means of questionnaire and multistage cluster sampling. The research data are based on the findings of the project for studying global values. Statistical population of the research consists of all people above the age of 16 in Iran, who were chosen by using Cochran Formula with a sample volume of 2275. Variables of religiosity, fathers' influence and patriarchy were conceptualized and operationalized and then used in testing research's assumptions by such measures as Cramer’s V and phi. Discussion of Results & Conclusion According to findings of the research, women are significantly more religious than men in all components of religiosity, including; religious values, religious beliefs, personal religious duties, religious consequences, thinking about meaning of life, prayer to God in addition to religious practices and belief in peacefulness of religion. In Iran, there are gender differences in religiosity and it can be said that women are more religious than men. Therefore, the first assumption (women are more religious than men) is confirmed. The only exception is that men take part in religious rituals more than women, but not in a significant level. This also verifies Loewenthal’s assertion that women do less religious activity than men do. Also, gender differences are not equal among Iranian Shias, Sunnis and Christians. The differences among Sunnis are more than among Shias, being in favor of women in both sects. But there is no gender difference among Christians. Therefore, the second assumption which, based on Loewenthal’s theory, asserts that gender differences in religiosity is culture-specific and vary among Christians, Muslims and Jews, is accepted. Loewenthal asserts that women take part in religious activities less than men. This is confirmed with regard to Shias and Sunnis, but not with regard to Christians. He also asserts that Muslim women are less religious than Muslim men, which is not acceptable according to the findings of this research. As mentioned before, Collet link gender differences to the power structure of family, asserting that girls who have been raised in patriarchal families have higher risk aversion and therefore are more religious. According to the findings of this research, however, these assumptions are not statistically acceptable. Therefore, the assertion that religiousness of women depends on the type of family (patriarchal or egalitarian) is rejected. The third assumption which, based on Collet theory, asserts that women in patriarchal families are more religious is rejected. These findings are highly important in view of sociological theory, because in the contemporary world in which power structure in most societies, including Iran, proceeds towards egalitarianism (Inglehart, 1993), (Azadarmaki, 2010), the rejection of this relation may denote the emergence of new structures in families and the possibility to preserve religious inclinations at the same time. The fact is that that acceptance of egalitarianism by families does not necessarily mean a reduction in religiosity. Considering gender studies which often emphasize discrimination against women due to social backgrounds and their inequality with men in some social aspects, studies such as the present one, which shows that gender differences are in favor of women, can have a positive effect on women. Their awareness about such abilities can help them play a more efficient role in their family and in their society, whereby improving their living standards and develop a better generation. In view of the importance of the subject, it is recommended that quantitative and qualitative studies to be conducted on gender differences in religiosity, its reasons and its contributing factors

Psychometric Properties of a Screening Instrument for Domestic Violence in a Sample of Iranian Women

Background: Domestic violence against women is regarded as an important health problem among women and a serious concern in issues related to human rights. To date, a few screening tools for domestic violence exist for Iranian married women, but they assess only some of the domestic violence components. Objectives: The present study aimed to design and determine the validity and reliability of a screening instrument for domestic violence in a sample of Iranian women. Materials and Methods: The present study was a cross-sectional psychometric evaluation conducted on 350 married women in Ilam, Iran, in 2014. The samples were selected through multistage sampling and the main method was cluster sampling. A 20-item, self-administered questionnaire was validated by exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). An Eigen value > and a loading factor > 0.3 for each component were considered as indices for extracting domestic violence components. Reliability was calculated by test-retest and Cronbach's alpha. Also, the content validity index (CVI) and content validity ratio (CVR) were used to measure content validity. The data were analyzed using SPSS-13 and LISREL 8.8 software programs. Results: The self-administered instalment was completed by 334 women. The CFA and EFA methods confirmed embedding items and the three-factor structure of the instrument including psychological, physical, and sexual violence, which explained 66 of the total variance of the domestic violence. The ICC and Cronbach's alpha coefficients were > 0.7 for the components of the questionnaire. The test-retest also revealed strong correlations for each of the domestic violence components (r > 0.6). Conclusions: The used instrument for measuring domestic violence had desirable validity and reliability and can be used as a suitable instalment in health and social researches in the local population

A case of allergic fungal otomastoiditis with aural polyps

While common in the paranasal sinuses, the presence of allergic mucin within the middle ear is rare. Here we describe a case of what has been termed allergic fungal otomastoiditis (AFOM), an unusual immunologic response to the presence of fungal hyphae within the middle ear, with a unique presentation of aural polyps. A 25-year-old woman presented with recurrent right-sided aural polyps and chronic otorrhea, despite two previous tympanomastoidectomy surgeries performed in India. CT scan of the temporal bones demonstrated complete opacification of the tympanic cavity and mastoid. Canal wall down tympanomastoidectomy was performed, revealing thick otorrhea and polyps filling the external auditory canal and middle ear, eroding the entire tympanic membrane and obstructing the antrum. Pathology revealed glandular and squamous metaplasia, marked inflammation with eosinophils, as well as allergic-type mucin with non-invasive fungal hyphae highlighted by GMS stain. The histopathologic findings of AFOM are reminiscent of allergic fungal rhinosinusitis (AFRS) and suggest a similar pathophysiology. Optimal treatment in these cases may require a combination of surgical debridement and medical management. AFOM should be considered in the differential diagnosis of chronic otitis media, particularly in the presence of aural polyps and thick otorrhea

Congenital Intralabyrinthine Cholesteatoma

A patient with a congenital intralabyrinthine cholesteatoma is presented. High-resolution computerized tomographic scans and intraoperative photomicrographs display features of intralabyrinthine extension. We discuss pathogenetic theories for the development of congenital intralabyrinthine cholesteatoma. The distinction of this condition from congenital cholesteatoma with labyrinthine erosion is discussed