Isolation, Characterization, and Antifungal Sensitivity Pattern of Candida Species Causing Otomycosis

Otomycosis is one of the overwhelming diseases both for patients and specialists with a high recurrence rate despite adequate and proper treatment. This study aims to investigate further the various types of fungi involved in otomycosis and test their susceptibility against common antifungals. In total, among candidiasis-suspected patients, 60 samples were incorporated into the study. PCR method was used for Candida species detection. Broth microdilution method of Clinical and Laboratory Standards Institute document M60 was applied to assess MIC values of rampant antifungals. We used SPSS software (version 16.0) for statistical analysis. In this survey, 20, 3, and 1 type of Candida albicans, Candida parapsilosis, and Candida glabrata were identified, respectively. All 20 C. albicans isolates were sensitive to amphotericin B (range 0.03-1 μg/ml), voriconazole, (0.03-1 μg/ml), and itraconazole (0.03-0.5 μg/ml.); moreover, one isolate was resistant to fluconazole. Two isolates out of three isolates of C. parapsilosis, were susceptible to all agents while the other one isolate was resistant to fluconazole. C. glabrata isolate was susceptible to all agents. In summary, the results conveyed the importance of clinicians remaining vigilant in diagnosing otomycosis due to its non-specific manifestations. To manage effectively otomycosis and avoid complications or recurrence, it is imperative to diagnose the condition at the earliest time, confirm its virulence through various tests, and identify antifungal susceptibility patterns. Despite this, relapse is often seen and achieving complete remission can prove to be a major hurdle in individuals who have had mastoidectomy and those with weakened immune systems

Safety and feasibility of simultaneous left and right heart catheterization via single-arm arterial and venous access

Background: Catheterization via the radial artery has become the method of choice for evaluation of the coronary arteries; however in patients requiring simultaneous coronary and right heart catheterization upper extremity access is not commonly used. Aims: In the present study we aimed to assess whether simultaneous left and right heart catheterization via the radial artery and antecubital vein might increase the vascular access site complications. Methods: In this prospective cohort study, 49 patients with congenital and valvular heart disease requiring both left and right heart catheterization were enrolled, and rates of vascular access complications, including radial artery obstruction (RAO), were compared to 49 subjects in the control group who underwent catheterization only via radial artery access. Results: No major vascular complications occurred in the study population. Post-procedural radial artery obstruction was detected in 14 patients (28.5%) in the venous-radial artery group and 7 (14.2%) in the control group (P = 0.09). Age, sex, body mass index, wrist circumference, hemoglobin concentrations, and history of smoking, diabetes mellitus, hypertension, and anticoagulant use did not affect the rate of radial pulse perseverance. However, shorter times of radial compression device removal were significantly related to lower rates of radial artery obstruction in both groups. Conclusion: Right and left heart catheterization via an upper-extremity route in patients with congenital and valvular heart disease is safe and practical with greater patient comfort and no serious vascular complications. A longer duration of radial compression is an important predictor of RAO, regardless of using additional upper-extremity venous access

Quality of Life Comparison in Common Rhinologic Surgeries

Various questionnaires are used in patients who undergo rhinologic surgeries but a unique comprehensive questionnaire is needed to evaluate quality of life (QOL) in rhinologic surgeries. The purpose of this study was to prepare a comprehensive questionnaire and compare QOL among four common rhinologic surgeries including functional endoscopic sinus surgery, septoplasty, septorhinoplasty, and septoplasty with turbinoplasty preoperatively and 6 months postoperatively. This was a prospective interventional before-and-after study. Preoperative and 6 months postoperative evaluations were performed with a Modified Health-Related Quality of Life (HRQL) questionnaire designed to cover all needed QOL aspects and the 22-item Sino-nasal Outcome Test questionnaire to cover all needed QOL aspects. The Modified HRQL included 33 items in six subgroups (nasal symptoms, sleep problems, headache, nonnasal symptoms, and practical and emotional problems) and general feeling. From 202 patients who completed the questionnaire before the procedures, 146 (72% of all patients) who were interviewed 6 months postoperatively were included in this study. Comparing preoperative data between followed up patients and missed patients showed no statistical difference among surgeries (p = 0.90). Comparison of patient's pre- and postoperative QOL showed a significant improvement in global QOL and in all questionnaire items (p < 0.0001 in all comparisons). Comparison of QOL changes before and after surgery among different surgeries revealed no statistical difference (p = 0.282). Our data showed a significant improvement in each surgery but the amount of improvement in different surgeries was almost constant

Rate of Occult Cervical Lymph Node Involvement in Supraglottic Squamous Cell Carcinoma

Introduction: To assess the rate of cervical lymph node involvement in patients with supraglottic squamous cell carcinoma (SCC) with no lymph node in clinical assessments and radiological studies. Materials and Methods: Fifty-six patients who underwent elective dissection of the cervical lymph node of the second through fourth level were enrolled, and pathologic evaluation of the dissected lymph nodes was performed. Lymph node involvement and association between tumor grade, smoking and gender with lymph node involvement were assessed. Results: The rate of the occult neck metastasis in this series was 37.5%. There was no statistically significant association between lymph node involvement and tumor grade, smoking, or gender. Conclusion: Based on the results of our study, we recommend elective bilateral neck dissection in all stages of N0 supraglottic SCC patients

HLA-DR association in papillary thyroid carcinoma

Abstract. Objective: Papillary thyroid carcinoma (PTC) is the most frequent types of thyroid malignancies. Several genes may be involved in susceptibility of thyroid cancer including Human Leukocyte Antigens (HLA). The association of thyroid carcinoma with HLA alleles has been previously studied in other populations and certain HLA alleles were shown to be either predisposing or protective. The aim of this study was to determine the association between HLA-DR and papillary thyroid carcinoma in an Iranian population. Design: HLA-DR antigen frequencies were determined in patients with papillary thyroid carcinoma (N = 70) and non-related healthy controls (N = 180) using PCR -SSP. Main Outcome: We found that HLA-DRB1*04 frequency was significantly higher in our patients compared to the controls [P = 0.02, OR; 1.9, 95% CI (1.04-3.57)]. Conclusions: Our results revealed HLA-DRB1*04 as predisposing factor in papillary thyroid carcinoma in Iranian population. This confirms the previous findings for associations between HLA-DRB1 and differentiated carcinomas in other populations