Hearing Status in Patients with Type 2 Diabetes Mellitus According to Blood-Sugar Control: A Comparative Study

Introduction: It seems that diabetes mellitus (DM) can affect the auditory system due to neuropathy, micro-vascular complications, and hearing cell damage during hyperglycemic states. In the current study, we aimed to compare hearing status in patients with type 2 DM (T2DM) according to their blood-sugar control status.   Materials and Methods: This cross-sectional study was carried out in 104 patients with T2DM attending the diabetic clinics of Guilan University of Medical Sciences within a period of 1 year (2014–2015). One group consisted of 52 patients with poor control and the other consisted of patients with moderate-to-good control (according to glycated hemoglobin [HbA1c] level). All subjects underwent pure tone audiometry (PTA) and distortion product otoacoustic emission (DPOAEs) assessments. A hearing threshold higher than 20 dB and a signal-to-noise ratio ≤3 in each frequency were considered abnormal.   Results: In PTA, poorly controlled patients showed more frequent hearing loss compared with the well-controlled group, especially at higher frequencies (8 kHz: 67.3% vs 46.2% [P=0.029]; 10 kHz: 46.2% vs 21.2% [P=0.025]). Also, patients in the poorly controlled group had worse cochlear function according to the DPOAE test (4 kHz: 32.7% vs 17.3% [P= 0.002] and 8 kHz: 70.6% vs 40.4% [P=0.006]).   Conclusion: DM and poor control status of diabetes can affect hearing sensation and cause hearing loss, especially at high frequencies. According to our findings, it seems that diabetic patients with a duration of diabetes >10 years, diabetic complications, poor control status or comorbidities should undergo both endocrine and audiologic follow-up to prevent greater sensory neural hearing loss

Comparative Scar Analysis Between V and Inverted-V Incision in Open Rhinoplasty of Patients Referred to Rasht Amir-Almomenin Hospital

Rhinoplasty has become one of the most commonly used surgeries in recent years. The visible columella scar is one of the problems of open Rhinoplasty. This study aims to compare the two common V and the inverted-V incisions in terms of their scar after open Rhinoplasty among patients. This comparative cross-sectional study was carried out on 394 open rhinoplasty patients from 2015 to 2016 in Amiralmomenin Hospital of Rasht. Half of the patients were treated with V incision and the other half with inverted-V. Subjective and objective scar assessment was done at least 12 months after surgery by using PSAS and CSAS questionnaires. Of 394 patients under study, 81% (319 cases) were female and 19% (75cases) were male. The subjects were at around the age of 28 ± 6 years and their Rhinoplasty surgery was performed 18 ± 6 months ago. In the subjective study, the final score of PSAS and its items (pain, itching, color, stiffness, thickness, irregularity) were not significantly different in the two studied incisions (p> 0.05). Also, in the objective study, the CSAS final score and its items (satisfactory, pigmentation and irregularity) didn’t show a significant difference in two under study incisions (p> 0.05). No significant difference was observed in forming scars in terms of individual and social variables and skin thickness in two groups (p> 0.05). The two v and inverted-v incisions have similar scar qualities. Besides, scar formation is not related to skin thickness and sex

Education of Medical Professionalism and the Role of Educators of Guilan University of Medical Sciences, Iran, According to its Residents

Background & Objective: There are many reasons that it is necessary to change the culture, educational environment, and curriculum of medical education toward addressing and developing the fundamentals of medical professionalism. The primary objective of this study was to assess the attitudes of residents about training professionalism in the School of Medicine in Guilan University of Medical Sciences, Iran. Methods: This descriptive study was conducted on 189 residents of Guilan University of Medical Sciences based on a questionnaire adjusted to culture and ethical issues of Iran in 2011-12. The reliability and validity of the questionnaire was confirmed. The data were analyzed by t-test and using the Stata statistical software. Results: In this study, 140 residents from 14 fields participated with mean age of 32.2 ± 4.49 years. More than 50% of residents rated the success of medical professionalism education programs as medium to high. More than 40% of them have considered the effect of role model educators, in the education of these principles, to be great. 62.9% of residents agreed with the theoretical–practical teaching of these principles. Conclusion: The degree of success of educational programs in various fields of medical professionalism was acceptable, but needs improvement. The residents acknowledge that they learn the principles of professionalism from their educators in a hidden educational curriculum, but believe that they must also be taught in theoretical and practical units. Keywords Medical professionalism Medical residents Education Role modelin

Co-occurrence of upper respiratory tract disorders with gastrointestinal infections of helicobacter pylori in patients: a systematic review and meta-analysis

Background: Helicobacter pylori infection and respiratory tract infection at the same time cause pathogenicity increase and death. The aim of this study was to evaluate the co-occurrence of upper respiratory tract disorders and gastrointestinal infections of H. pylori. Methods: The present study was conducted as a systematic review and meta-analysis, from August 2019 to Agusut 2020, at Qazvin University of Medical Sciences. Articles in the international databases (April 2001-December 2018) on the coexistence of upper respiratory tract disorders with H. pylori gastrointestinal infections were examined. The random effect model with a 95% confidence level was used to analyze the data. Results: The highest prevalence of respiratory disorders co-occurrence associated with adenoid tissue (33%), nasal polyps (100%), chronic rhinosinusitis (71%) and gastrointestinal infections of H. pylori was reported in 2006 in Turkey, 2011 in Poland and 2015 in Egypt .Concurrent prevalence of the disease, according to the type of upper respiratory tract disorders in all studies, the estimated effect size according to the random model was 53% in chronic rhinosinusitis, 63% in nasal polyps, 62% in adenoid tissue and 60% in total, which was significant (P=0/000). The prevalence of co-occurrence of upper respiratory tract disorders with gastrointestinal infections of H. pylori in patients was estimated to be 61% at the age of more than 27 years and 60% at the age of fewer than 27 years. Pooled estimation of the concurrent prevalence of infection (in total) was estimated to be 60% and was significant among the studies (P=0/000). Conclusion: The concurrent prevalence of upper respiratory tract disorders with gastrointestinal infections of H. pylori was observed to be almost equal and significant in elderly and young patients. Due to the fact that the simultaneous occurrence of two types of infections and diseases in people is very dangerous, screening of patients with each of these infections is necessary to identify the other infection and prescribe appropriate drugs

Frequency of Minor Skin and Soft Tissue Complications in Facial and Periorbital Area after Septorhinoplasty

Introduction: High prevalence of rhinoplasty in the community and lack of structured studies about its minor skin and soft tissue complications, point out the necessity of performing precise and comprehensive studies. The aim of this study was to determine the frequency of minor cutaneous and soft tissue complications of rhinoplasty.  Materials and Methods: 110 patients (30 Male and 80 Female, Mean age: 26.3± 6.8) participated in this study. Before surgery all of them were checked for having each of intended complications, and 1 and 3 months after the surgery, they underwent serial visits for monitoring skin & soft tissue complications. The software used for data analysis was SPSS ver.16.  Results: Acne exacerbation was seen in 27% of cases in first post-surgical visit. Nasal tip paresthesia was the most frequent complication in both postsurgical visits (49.6% in first and 36.3% in second visit), followed by eyebrow loss (31.8%), complaint of increased yawning (31.8%), periorbital hyperpigmentation (21.8%) in first visit, and, hyperpigmentation (19.1%), complaint of increased yawning (10%) and surgical site scar (7.2%) in second visit respectively. The frequency of complications was highest in younger than 25 year old age group.  Conclusion: Having knowledge about these complications helps us to know which of them needs prompt medical intervention and which of them will resolve with time and just needs giving reassurance to the patient

Brain Single Photon Emission Computed Tomography in Anosmic Subjects Ater Closed Head Trauma

Anosmia following head trauma is relatively common and in many cases is persistent and irreversible. The ability to objectively measure such a decline in smelling, for both clinical and medicolegal goals, is very important. The aim of this study was to find results of brain Single Photon Emission Computed Tomography (SPECT) in anosmic subjects after closed head trauma. This case-control cross sectional study was conducted in a tertiary referral University Hospital. The brain perfusion state of nineteen anosmic patients and thirteen normal controls was evaluated by means of the SPECT with 99mtc- ECD infusion- before and after olfactory stimulation. The orbitofrontal lobe of the brain was assumed as the region of interest and changes in perfusion of this area before and after the stimulations were compared in two groups. The mean of brain perfusion in controls before and after the stimulation was 8.26% ± 0.19% and 9.89% ± 0.54%, respectively (P < 0.0001). Among patients group, these quantities were 7.97% ± 1.05% and 8.49% ± 1.5%, respectively (P < 0.004). The difference between all the measures in cases and controls were statistically significant (P < 0.0001). There were no differences in age and sex between two groups. The brain SPECT is an objective technique suitable for evaluating anosmia following the head trauma and it may be used with other diagnostic modalitie

Benign Paroxysmal Positional Vertigo Prevalence in Meniere’s Disease: Is Meniere\'s Disease a Predisposing Factor?

Background: Meniere’s disease (MD) is a chronic illness defined as an idiopathic syndrome of endolymphatic hydrops. Benign paroxysmal positional vertigo (BPPV) is a balance disorder and can be the sequel of diverse inner ear impairments. Objectives: The purpose of this study was to investigate the prevalence of BPPV in MD patients. Materials and Methods: All patients with definite or probable MD participated in this cross-sectional descriptive and analytic study between March 2013 and February 2014. We used the American Academy of Otolaryngology–Head and Neck Surgery (AAO-HNS) criteria plus electrocochleography (ECochG) test results to define the presence of MD and positional tests to determine the presence of BPPV. The frequency was reported. Independent sample t-test was also used in SPSS19. Results: A total of 39 patients (43 ears) with definite or probable MD (26 female, 13 male mean age: 46.4 ± 9.2 years) were enrolled in this study. Six out of 39 cases (15.4%) had BPPV in the posterior semicircular canal. The mean duration of MD was 28.5 months in BPPV group and 13.2 months in the non-BPPV group. Regardless of the age of the patients, there was a significant difference (p = 0.02) between the duration of MD in the two groups. Conclusions: It seems that MD and BPPV are related and a longer duration of MD may result in a greater risk of developing BPPV

Brainstem auditory evoked response characteristics in normal-hearing subjects with chronic tinnitus and in non-tinnitus group

Background and Aim: While most of the people with tinnitus have some degrees of hearing impairment, a small percent of patients admitted to ear, nose and throat clinics or hearing evaluation centers are those who complain of tinnitus despite having normal hearing thresholds. This study was performed to better understanding of the reasons of probable causes of tinnitus and to investigate possible changes in the auditory brainstem function in normal-hearing patients with chronic tinnitus.Methods: In this comparative cross-sectional, descriptive and analytic study, 52 ears (26 with and 26 without tinnitus) were examined. Components of the auditory brainstem response (ABR) including wave latencies and wave amplitudes were determined in the two groups and analyzed using appropriate statistical methods.Results: The mean differences between the absolute latencies of waves I, III and V was less than 0.1 ms between the two groups that was not statistically significant. Also, the interpeak latency values of waves I-III, III-V and I-V in both groups had no significant difference. Only, the V/I amplitude ratio in the tinnitus group was significantly higher (p=0.04).Conclusion: The changes observed in amplitude of waves, especially in the latter ones, can be considered as an indication of plastic changes in neuronal activity and its possible role in generation of tinnitus in normal-hearing patients

Otoacoustic Emissions in Sudden Sensorineural Hearing Loss: Changes of Measures with Treatment

Introduction: To identify changes in OAEs parameters in treatment course of idiopathic sudden sensorineural hearing loss (iSSNHL). Materials and Methods: In aprospective studyfromAugust 2005 to January 2009, 26 patients with iSSNHL underwent conventional audiometry/tympanometry and two types of OAEs (TEOAEs and DPOAEs) before and after the completion of standard drug therapy.The changes in pre- and post- treatment parameters were compared with each other and with normal-contralateral ears. Results: In TEOAEs, the mean overall correlation (reproducibility) and the mean overall strength in involved ears were 10.96±23.36 and 0.99±3.45 dB, respectively, before the treatment, which reached 22.88±36.55 and 1.85±5.3, respectively, after the treatment (P>0.05). Significant difference between “correlation score” (average of correlations at 3-4 involved frequencies) before and after treatment was found: 6.52 ±18.19 vs. 21.67±37.8 (