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

Evaluation of the relashionship between clinical findings before tympanoplasty and ossicular discontinuity and erosion in patients with chronic otitis media

Background: Chronic Otitis Media (COM) is a relatively common condition and the occurrence of hearing loss is probable. COM may lead to ossicular discontinuity, and unless the operation is performed, it won't be determined. Identifying possible cases of erosion and discontinuity of ossicles is helpful in surgical planning and in anticipation of the probable need for procuring ossicular prosthesis.Purpose: The aim of this study was to evaluate the relationship between preoperative clinical findings and intraoperative findings.Methods: This is a cross sectional study carried out in 2012 in two tertiary referral hospitals of Tehran, (the Loghman and the Taleghani hospitals). The sample under study consisted of COM patients who referred to the otolaryngology clinics and were tymponoplasty candidates. Two hundred and seven  patients with the mean age of 36.2±13.9 (ranging from 9-67 years) were enrolled in the study. Pre-surgical findings were investigated and the relationship between ossicular discontinuity and pre-surgical findings were evaluated.Results: Incus-Stapes discontinuity (IS Discontinuity) and Incus-Malleus discontinuity (IM Discontinuity) were seen in 60 (29%) and 25 (12.1%) patients, respectively. We found IS Discontinuity in 38 (24.1%) patients with central perforation and 22 (48.9%) cases of marginal perforations (P=0.005). IM Discontinuity was observed in 14 (8.9%) cases with central perforation, while this was seen in 11 (22.4%) cases with marginal perforations (P=0.011). On the other hand, 34 (42%) patients with otorrhea had IS Discontinuity whereas 26 (20.6%) cases of dry ears showed this type of ossicular problem (P<0.001). IM Discontinuity was detected in 13 (16%) and 12 (9.5%) cases with and without otorrhea, respectively (P=0.011). IS Discontinuity and IM Discontinuity were significantly more common in the patients with Air Bone Gap of more than 40 db.Conclusion: Our finding showed that surgical results may be unpleasant in the patients with marginal perforation, otorrhea and ABG>40 db

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

Comparing OAE and ABR Tests in Tinnitus Patients with and without Hearing Loss

Background: Tinnitus is the perception of sound in the absence of any external stimulus. It may be generated by abnormalities in both peripheral or central auditory system. The auditory tests are useful tools for the evaluation of tinnitus origin.Purpose: In this study, we compared the results of OAE( Otoacoustic Emissions) and ABR (Auditory Brainstem Response) hearing tests among patients with tinnitus without hearing loss and patients with tinnitus and hearing loss.Methods: In this cross-sectional study, 60 patients with tinnitus were enrolled and were divided into two groups; a group without hearing loss and other group with hearing loss. DPOAE (Distortion Product Otoacoustic Emissions) TEOAE (Transient Evoked Otoacoustic Emissions), and ABR were performed for all patients with tinnitus referring to ENT clinic of Taleghani Hospital during 2014.Results: In the present study, 60 patients with a mean age of 52.76±15.69,  including 37 (61.7%) male and 23 (38.3%) female, were studied. Patients without hearing loss were younger than those with hearing loss (P=0.001). The mean Speech Reception Threshold (SRT) in the group without hearing loss in both ears  was significantly lower than patients with hearing loss (P=0.001). The difference between two groups regarding ABR in right ear in waves I, V, and I-V was statistically significant (P<0.05).  In patients without hearing loss there was a significant difference between two age groups (>55 and ≤55 years) in wave III of ABR in left ear (P=0.03).Conclusion: We revealed that SRT and ABR in waves I, V, and I-V in the group with hearing loss were higher than patients without hearing loss

رأي أساتذة جامعة همدان للعلوم الطبية حول الصحة ودورها في تحقق أسلوب الحياة الإسلامية

سابقه و هدف: سبک زندگی مشخصۀ بارز هویت فرهنگی و اجتماعی هر جامعه‌ای است. اسلام و مفاهیم و آموزه‌های آن خود مقوم و سازندۀ بهترین سبک زندگی است. اگرچه سبک زندگی اسلامی مولد ابعاد مختلف سلامتی است، سلامت یا فقدان آن می­تواند از عوامل تسهیل‌کننده یا بازدارندۀ تحقق سبک زندگی اسلامی نیز باشد. بنابراین مطالعۀ حاضر برای تبیین دیدگاه استادان دانشگاه علوم پزشکی همدان دربارۀ سلامت و نقش آن در تحقق سبک زندگی اسلامی اجرا شده است. روش کار: این پژوهش مطالعه‌ای کیفی با رویکرد تحلیل محتوا است. جمع‌آوری داده­ها از طریق مصاحبۀ عمیق نیمه‌ساختاریافته با 11 نفر از استادان دانشگاه علوم پزشکی همدان به‌روش نمونه‌گیری مبتنی بر هدف با حداکثر تنوع از نظر سن و وضعیت هیئت علمی صورت گرفت. همۀ مصاحبه­ها دست‌نویس شد و در پایان با روش تحلیل محتوای قراردادی تجزیه و تحلیل شد. مشارکت‌کنندگان و محققان استحکام و صحت داده­ها را تأیید کردند. در این پژوهش همۀ موارد اخلاقی رعایت شده است و مؤلفان مقاله تضاد منافعی گزارش نکرده‌اند. یافته‌ها: تحلیل داده­ها به استخراج مفاهیمی اصلی منجر شد که عبارت است از: تأثیر ضعیف سلامت جسمی بر تحقق سبک زندگی اسلامی (درون‌مایۀ فرعی؛ تعاریف متنوع از سلامت جسمی و تأثیرات متناقض سلامت جسمی)، تأثیر مثبت سلامت روانی بر تحقق سبک زندگی اسلامی (درون‌مایۀ فرعی؛ ارتباط قوی سلامت روانی و تأثیر مستقیم سلامت روانی)، تأثیر متقابل سلامت اجتماعی بر تحقق سبک زندگی اسلامی (درون‌مایۀ فرعی؛ تعاریف مختلف از سلامت اجتماعی، تأثیر دوطرفۀ سلامت اجتماعی و نظارت حاکمیت بر بُعد سلامت اجتماعی) و تأثیر تصاعدی سلامت معنوی بر تحقق سبک زندگی اسلامی (درون‌مایۀ فرعی؛ امکان‌پذیر نبودن سبک زندگی اسلامی بدون سلامت معنوی). نتیجه‌گیری: بر اساس یافته‌های به‌دست‌آمده، سلامت روان انسان مهم‌تر از سلامت جسم او و بیماری روان او مهم‌تر از بیماری جسم است. بنابراین سلامت روانی و معنوی می‌تواند به‌خوبی تحقق سبک زندگی اسلامی را تبیین نماید، هرچند تلاش برای زدودن بیماری­های جسمی در یاری افراد جهت تحقق هرچه بهتر سبک زندگی اسلامی لازم است.   استناد مقاله به این صورت است: Shourcheh B, Barati B, Afshari M. The Views of Hamadan University of Medical Sciences Professors about Health and its Role in Realizing Islamic Lifestyle. Journal of Pizhūhish dar dīn va salāmat. 2021;7(1):52-62. https://doi.org/10.22037/jrrh.v7i1.27621Background and Objective: Lifestyle is the hallmark of any society's cultural and social identity. Islam and its concepts and doctrines constitute the best lifestyle. Although Islamic lifestyle produces health in different aspects, health or lack thereof can also be a facilitator of or obstacle to the realization of Islamic lifestyle. Therefore, the present study was conducted to investigate the views of Hamadan University of Medical Sciences professors regarding health and its role in the realization of Islamic lifestyle. Methods: This qualitative study was conducted using content analysis approach. Data were collected through in-depth semi-structured interviews with 11 professors of Hamadan University of Medical Sciences selected through purposeful sampling with maximum variation in age and faculty status (Sciences). All the interviews were transcribed and finally analyzed using the conventional content analysis. The robustness and accuracy of the data were confirmed by the researchers and the researchers. In this study, all ethical considerations were observed and no conflict of interest was reported by the authors. Results: Data analysis led to the extraction of the main concepts including the poor effect of physical health on the realization of Islamic lifestyle (with sub-themes of various definitions of physical health and the contradictory effects of physical health), the positive impact of mental health on the realization of Islamic lifestyle (with sub-themes of the strong relationship with mental health and the direct impact of mental health on the realization of the Islamic lifestyle), the mutual relationship between social health and the realization of Islamic lifestyle (with sub-themes of different definitions of social health, the two-way impact of social health, and governmental supervision and control over the dimension of social health) and the exponential impact of spiritual health on the realization of the Islamic way of life (with sub-themes of impossibility of the Islamic lifestyle without spiritual health), respectively. Conclusion: Based on the findings, mental health is more important than physicla health and mental illnesses are more serious than physical ones. Therefore, mental and spiritual health can well explain the realization of the Islamic lifestyle, although there is also a need to eliminate physical ailments to help individuals achieve a better Islamic lifestyle.   Please cite this article as: Shourcheh B, Barati B, Afshari M. The Views of Hamadan University of Medical Sciences Professors about Health and its Role in Realizing Islamic Lifestyle. Journal of Pizhūhish dar dīn va salāmat. 2021;7(1):52-62. https://doi.org/10.22037/jrrh.v7i1.27621خلفية البحث وأهدافه: يعتبر أسلوب الحياة من المعالم البارزة للهوية الثقافية والاجتماعية لكل مجتمع. ويُعتبر الإسلام ومفاهيمه وتعاليمه مقوّماً وأساساً لأفضل أسلوب من أساليب الحياة. ورغم أن أسلوب الحياة الإسلامية يُنتج أبعاداً مختلفة للصحة، ولكن الصحة أو فقدانها بدورها يمكن أن تكون عاملاً مساعداً أو معيقاً لتحقق أسلوب الحياة الإسلامية أيضاً. ومن هنا فإن هذه الدراسة قد تم إنجازها بغرض تبيين رؤية أساتذة جامعة همدان للعلوم الطبية حول الصحة ودورها في تحقق أسلوب الحياة الإسلامية. منهجية البحث: تعتبر هذه الدراسة مراجعة كيفية بمنهج تحليل المضمون. وقد تم جمع بيانات الدراسة عن طريق المقابلات الموّسعة نصف الهيكلية مع أحد عشر شخصاً من أساتذة جامعة همدان للعلوم الطبية بمنهج أخذ العينات القائم على الهدف، مع الحد الأكثر من التنوع من جهة السن والجنس والعضوية في الهيئة العلمية. وقد تمت كتابة جميع المقابلات، وفي النهاية تم تحليلها وتفكيكها من خلال منهج تحليل المضمون الوضعي. وقد أيّد المشاركون والمحققون دقة وصحة البيانات. وقد تمت مراعاة جميع الضوابط الأخلاقية في هذه الدراسة، ولم يلحظ مؤلفو المقالة أي تعارض للمنافع. الكشوفات: أدى تحليل المعطيات إلى استنباط مفاهيم أساسية وهي عبارة عن: التأثير الضعيف للصحة البدنية على تحقق أسلوب الحياة الإسلامية (مواضيع فرعية، التعاريف المتعددة للصحة البدنية والتأثيرات المتناقضة للصحة البدنية)، والتأثير الإيجابي للصحة النفسية على تحقق أسلوب الحياة الإسلامية (مواضيع فرعية، العلاقة القوية للصحة النفسية والتأثير المباشر للصحة النفسية)، والتأثير المتبادل للصحة الاجتماعية على تحقق أسلوب الحياة الإسلامية (مواضيع فرعية، التعاريف المتعددة للصحة الاجتماعية، والتأثير المتقابل للصحة الاجتماعية ورقابة الدولة على مجال الصحة الاجتماعية)، والتأثير التصاعدي للصحة المعنوية على تحقق أسلوب الحياة الإسلامية (مواضيع فرعية، استحالة أسلوب الحياة الإسلامية بدون الصحة المعنوية). الاستنتاج: طبقاً للمعطيات المتوفرة فإن الصحة النفسية للإنسان تعتبر أهم من صحته البدنية، كما أن مرضه النفسي يعتبر أهم من مرضه البدني. وبناءً على هذا، فإن الصحة النفسية والروحية تستطيع أن تكشف بوضوح عن تحقق أسلوب الحياة الإسلامية، رغم ضرورة السعي لرفع الأمراض البدنية من أجل مساعدة الأفراد في تحقق أسلوب الحياة الإسلامية بنحو أفضل.   يتم استناد المقالة على الترتيب التالي: Shourcheh B, Barati B, Afshari M. The Views of Hamadan University of Medical Sciences Professors about Health and its Role in Realizing Islamic Lifestyle. Journal of Pizhūhish dar dīn va salāmat. 2021;7(1):52-62. https://doi.org/10.22037/jrrh.v7i1.2762

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)

Otological Findings Ten Years after Myringotomy with Tympanostomy Tube Insertion

Introduction: To study the long-term complications of tympanostomy tube insertion in young children 10 years after surgery.   Materials and Methods: In September 2011, the medical records of all patients who had undergone myringotomy with tympanostomy tube insertion between February 2000 and March 2001 at the two general hospitals of Isfahan University of Medical Sciences were studied. Of the 98 patients who fulfilled the inclusion criteria, 82 patients agreed to participate and were enrolled in the study. The complications of the operation were evaluated in these patients.   Results: Of the 164 ears that were operated on, myringosclerosis was found in 17.1%, atrophy of the tympanic membrane in 1.2%, permanent perforation of the tympanic membrane in 0.6% and tympanic membrane atelectasis in 0.6%. None of the patients developed cholesteatoma as a complication of tympanostomy tube insertion.   Conclusion:  Considering the low risk of serious complications after 10 years, tympanostomy tube insertion is a safe and effective treatment option in the treatment of otitis media with effusion

Treatment of adenotonsillar hypertrophy: A prospective randomized trial comparing azithromycin vs. fluticasone

Background: The aim of this study was to compare the efficacy of azithromycin vs. fluticasone in treatment of adenotonsillar hypertrophy (AH). Methods: In a clinical trial, 39 AH patients were selected using a convenient time-based sequential sampling method. The subjects were randomized into two treatment groups. Patients in group A (fluticasone) and B (azithromycin) were respectively treated with fluticasone spray and azithromycin suspension for a 6-week period. Data regarding the grade of obstruction (based on tonsillar size), level of adenotonsillar hypertrophy, and obstructive sleep apnea (OSA) symptoms (including mouth breathing, snoring, hyponasal speech, and sleep apnea) were collected by a self-administrated questionnaire before treatment, as well as 1 week and 8 weeks after treatment. Results: Twenty AH patients in group A and 19 AH patients in group B were studied. AH related symptoms, including mouth breathing, snoring, hyponasal speech and sleep apnea, improved significantly in both groups (p < 0.05). We also found a statistically significant reduced grade of obstruction among patients in both groups. However, fluticasone was not effective on adenotonsillar hypertrophy. One week after treatment, outcomes related to apnea and hyponasal speech were better in group B than group A. Decreases in mouth breathing and snoring were not significantly different between group A and B. Conclusions: It could explain that though both of the improved and mentioned symptoms comparing within initial status, Azithromycin seems to be more effective than fluticasone in improving AH-related symptoms. Short term efficacy of the antibiotic is much significant than its long term effect

Otological Findings Ten Years after Myringotomy with Tympanostomy Tube Insertion

Abstract Introduction: To study the long-term complications of tympanostomy tube insertion in young children 10 years after surgery

Outcome of Pectoralis Major Mayocutaneous Flap in Reconstruction of Maxillofacial Defects

Introduction: The aim of the present study was to evaluate outcomes and complications related to pectoralis major mayocutaneous (PMM) flaps in the reconstruction of maxillofacial defects. Materials and Methods: Subjects who underwent pectoralis major mayocutaneous flaps to reconstruct maxillofacial defects due to trauma or tumor resection were studied. Complications were considered in two stages: early and late. A modified version of the University of Washington Quality of Life questionnaires, version 4, was used to evaluate the functional outcome of patients who underwent free flap or PMM flap reconstruction. The survey is composed of 6 domains: pain, appearance, activity, swallowing, chewing, and speech. We scored domains on a scale ranging from 0 (worst) to 100 (best). We considered scores higher than 70 in the normal range for appearance, activity, swallowing, chewing, and speech. Results: Thirty-one subjects were studied. The most common defect sites were oral floor (48.3%) and buccal soft tissue (32.2%). The least common was neck (19.3%). Immediate complications consisted of dehiscence in 3 cases (9.6%) and flap necrosis in 2 cases (6.4%). Late complications included dehiscence in 3 cases, partial necrosis of skin without muscle necrosis in 1 case, and donor site infection in one case. The most common complications seen in both stages were dehiscence (19.3%) and necrosis (9.6%).In the immediate phase, patients mostly complained of pain. In the late stage, pain significantly decreased. Activity, swallowing, and speech improved in the late stage. Conclusion: Our study indicated a significant improvement in patients' functional outcomes after discharge from the hospital. The pain was a major complaint of patients immediately after reconstruction with PMM flap, which should be considered as a significant concern for maxillofacial surgeons