The Influence of PDS in Patients under Septoplastic Surgery

Background: It is a well-known fact that deviation of bony or cartilaginous septum can induce airway obstruction. Therefore, fixing the deviated part in a refined and straight line is one of the substantial challenges in otolaryngology. There are huge varieties of methods to eliminate this deviation.Aim: In this study, we desire to assess the efficiency of polydioxanone plate (PDS), fixed to the cartilage of nasal septum, to determine the mechanical safety over septoplasty, as the components of cartilage had been healed.Methods: In the following study, 48 patients with septal deviation, referring to an academic hospital in Iran for one year, were investigated. They underwent external and endoscopic septoplasty combined with the polydioxanone plate. The data was gathered in a questionnaire including the deviation of nasal septum, infection, septal hematoma, saddle nose, columella retraction and polly beak deformity.Results: Due to the septal injury resulted from trauma, a total of 27.1% patients was transferred to our hospital. Our results showed the cause and type of septal deviation had no effect on surgical results (p = 0.3), and acute complications were observed in only two patients (4.2%). After 3-6 months of follow up, 5 patients (10.42%) had long-term complications, while satisfactory results were obtained in 39 subjects (83%).Conclusion: Absorbable plate, polydioxanone, connected to cartilage was found safe and effective. It could facilitate the modification rates of surgical processes in septal deviation and had the ability to support the nasal dorsum till it gradually get recovered, without the long-term complications occurring in other techniques

Tongue-in-Groove technique for Reconstruction of Nasal Tip Ptosis due to Rhinoplasty, A Cross-Sectional Study

Background: nasal tip ptosis is believed to be one of the most common nasal malformations with a relatively high prevalence in patients who underwent rhinoplasity operation. A variety of techniques has been defined for the surgical modification of tip ptosis. The TIG technique seems to be a multipurpose surgical approach for the modification of nose in the lower third region. TIG could be appropriate in the primary and most modified cases and to show better results, it has been integrated with other surgical systems.Aim: The aim of this study is to investigate TIG technique in patients with nasal tip ptosis after Rhinoplasty, referring to Loghman-E- Hakim hospital, Tehran, Iran.Methods: In following descriptive cross-sectional study, surgical operation was carried out in thirty-three patients suffering from nasal tip ptosis between 2012 and 2013 using the described technique. The data were gathered in a questionnaire designed for this purpose. At the end, the degree of nasal ptosis was determined in these patients.Results: In this study, nasal shape was desirable in 75.7% of patients and there was no case of nasal ptosis. 82.8% of the patients were satisfied with the results. 81.1% of patients have not any complications. Other factors did not associate with nasal ptosis (P> 0.05).Conclusion: based on the results of this study and their comparison with other studies conducted in this field, TIG method after rhinoplasty can reduce nasal ptosis. Thus, it can be deduced they will be proper in the both primary and most revision cases.

The Outcomes of Dome Cut in Rhinoplasty versus Alternative Methods in Patients with Various Nasal Tip Deformities

Background: There were several techniques for reconstruction of nasal tip cartilage. Dome cut is a technique that has recently proposed for nasal tip projection, this method is recently concern regarding its efficacy.  Aim: This study was performed to determine the outcomes of rhinoplasty with dome cut vs. alternative methods in patients with various nasal tip deformities. Methods: A retrospective review from 36 cases was conducted. Patients were selected from a computerized rhinoplasty database of operative cases. The database was used to extract a subset population that had received the dome cut procedure and had follow-up data for 6 months or more after surgery. Patient satisfaction, physician evaluation, physical examination, blinded comparison of preoperative and postoperative photographs, and revision surgery necessitation were also analyzed in this review of results and complications. Results: Initially 41.7 percent had saddle nose deformity, 41.7% had nasal tip deformity, and 16.7% had other types of deformity. 94.4% had successful outcomes whether the technique and type of deformity had no effect on success of results (p > 0.05). Conclusion: According to the obtained results and comparison with other studies, it may be concluded that rhinoplasty with dome cut is a successful method and various methods and deformities have no effect on the outcomes

Cardiogenic Shock Following Acute Myocardial Infarction: A Retrospective Observational Study

Introduction: Cardiogenic shock is a sudden complication that occurs in 5 to 10% of patients with acute myocardial infarction. According to statistics, mortality and morbidity from this event, despite all hospital care, are approximately 70-80%.Methods: This study was conducted over three years (2012 to 2014) in 28 cases of acute myocardial infarction, which was complicated by cardiovascular shock, before or after admission. We compared the outcomes of patients according to the treatment strategy, thrombolytic therapy, primary percutaneous coronary intervention (PCI), or other medical stabilization. The 30-day follow-up was the first endpoint, and the 3- month follow up was the second endpoint of the study.Results: 28 patients with cardiogenic shock included in this study. The mean (± SD) age of the patients was 62.99 ± 13.99 years. The median time to the onset of shock was 648.75 ± 1393.58 minutes after infarction. Most of the patients who underwent coronary angiography had 3-vessel or left main involvement. Two patients missed in follow up and five (80%) patients who received thrombolytic therapy passed away. Nine (100%) patients in the medical stabilization group and six patients (50%) underwent primary PCI group passed away too. The mortality in the primary PCI group was significantly lower than the other groups (P = 0.04).Conclusion: Although cardiogenic shock is a potential risk of early death, it is important that the thrombolytic in these patients doesn't increase survival and the primary PCI is more effective than thrombolytic agents

Efficacy and safety of sofosbuvir in the treatment of SARS-CoV-2: an open label phase II trial

Objective: Despite the worldwide spread of the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), an effective specific antiviral treatment for coronavirus disease of 2019 (COVID-19) is yet to be identified .We did this study to investigate the safety and efficacy of sofosbuvir as antiviral therapy among hospitalized adult patients with SARS-CoV-2. Methods: Patients were randomized into intervention arm receiving sofosbuvir or comparison arm receiving usual antiviral agents in addition to standard of care. The primary end point of the study was clinical recovery as defined by normal body temperature and normal oxygen saturation. The main secondary outcome was all-cause mortality during the admission in hospital or within 14 days after discharge if applicable. Reports of severe adverse events were observed in the intervention arm. Results: Fifty-seven patients enrolled into either the clinical trial arm (n=27) or the comparison arm (n=30). Primary outcome was achieved by 24 (88.9%) and 10 (33.3%) in the intervention and comparison arms, respectively. Median hospital length of stay was significantly shorter in the intervention arm (10 days [IQR: 5-12] vs. 11.5 days [IQR: 8.5-17.75], P = 0.016). All-cause mortality was two and thirteen in intervention and comparison groups, respectively. No serious adverse events were reported by the patients receiving sofosbuvir during the study. Conclusion: Among patients hospitalized with SARS-CoV-2, those who received sofosbuvir had more clinical recovery rate and had a shorter hospital length of stay than those who received usual antiviral agents in the study and these differences were statistically significant

Clinical Characteristics of Fatal Cases of COVID-19 in Tabriz, Iran: An Analysis of 111 Patients

Introduction: The rapid worldwide spread, in addition to the morbidity and mortality associated with the novel coronavirus disease 2019 (COVID-19), have raised concern throughout the world. Identifying the characteristics of patients who died of COVID-19 is essential to implement preventive measures. Objective: We aimed at investigating these characteristics among the Iranian population in Tabriz. Methods: In this case series, we analyzed clinical characteristics, laboratory parameters, and imaging findings of 111 patients with a reverse transcriptase-polymerase chain reaction (RT-PCR)-confirmed COVID-19 diagnosis who died during hospitalization. The studied patients had been admitted to the hospital between February 2020 and May 2020. Results: The median age of patients was 73 years (IQR, 62-82 years) and approximately 70% of them were male. The median oxygen saturation on admission was 88% (IQR, 80-92%) and dyspnea, cough, and fever were the most common presenting symptoms. Among comorbidities, diabetes, hypertension, and cardiovascular diseases were more frequently observed among patients who had a fatal outcome. While ground-glass opacity was the most commonly reported finding on chest computed tomography, 5% of the patients had no abnormal finding on imaging. Chloroquine was the most frequently used medication for treatment. Conclusion: Our results showed that the majority of COVID-19 deaths occurred in male elderly with decreased levels of oxygen saturation and elevated levels of lactate dehydrogenase and erythrocyte sedimentation rate on admission

New‐onset ANCA‐associated vasculitis presenting with neuropathy after COVID‐19 infection: A case report and literature review

Key Clinical Message Coronavirus Disease 2019 (COVID‐19) is a viral infection caused by SARS‐CoV‐2, which can trigger autoimmune diseases such as antineutrophilic cytoplasmic antibody (ANCA) associated vasculitis (AAV) that affect small and medium‐sized blood vessels in multiple organs. This study discusses a case with neuropathy and positive ANCA after COVID‐19 infection and reviews the literature on AAV following COVID‐19 infection. A 59‐year‐old man is presented that was referred to Shariati Hospital for evaluation of neurologic problems after a COVID‐19 infection. Initially, he had flu‐like symptoms. A few days later, he developed right distal upper and lower limb paresthesia. His electromyography (EMG) and nerve conduction velocity (NCV) results were consistent with polyneuropathy. Lumbar puncture (LP) was normal except for positive COVID‐19 polymerase chain reaction (PCR). The patient's paresthesia worsened. Laboratory data showed leukocytosis, anemia, thrombocytosis, high erythrocyte sedimentation rate (ESR), and C‐reactive protein (CRP). Perinuclear anti‐neutrophil cytoplasmic antibody (MPO‐ANCA) was positive. According to the results, vasculitis was the main differential diagnosis. The sural nerve biopsy was performed, and the result was consistent with small to medium‐sized vessel vasculitis. The patient was diagnosed with COVID‐induced AAV. He was prescribed methylprednisolone and cyclophosphamide and was discharged with prednisolone and cotrimoxazole. In this study, a unique case of AAV induced by COVID‐19 infection confirmed by nerve biopsy is presented. A review of the literature found 48 cases of new‐onset AAV in adults and pediatrics after COVID‐19 infection. Further research is needed to completely understand the relationship between COVID‐19

Prevalence, Risk Factors and Outcomes Associated with Acute Kidney Injury in Patients Hospitalized for COVID-19: A Comparative Study between Diabetic and Nondiabetic Patients

Background. The risk factors for acute kidney injury (AKI) development in patients with diabetes hospitalized for COVID-19 have not been fully studied yet. In this study, we aimed to estimate the rate of AKI among the hospitalized population with COVID-19 and to identify the risk factors associated with AKI among patients with diabetes. Material and Methods. This retrospective cohort study included 254 patients (127 with diabetes and 127 without diabetes) who were admitted for COVID-19 to a tertiary hospital in Tehran, Iran, between February and May 2020. Clinical characteristics and outcomes, radiological findings, and laboratory data, including data on AKI, hematuria, and proteinuria were recorded and analyzed. Results. Of 254 patients, 142 (55.9%) were male and the mean (± SD) age was 65.7 years (±12.5). In total, 58 patients (22.8%) developed AKI during hospitalization, of whom 36 patients had diabetes (p=0.04); most patients (74.1%) had stage 1 or 2 AKI. Also, 8 patients (13.8%) required renal replacement therapy (RRT) after developing AKI. Regardless of diabetes status, patients who developed AKI had significantly higher mortality rates compared with patients who did not develop AKI (p=0.02). Hematuria and proteinuria were observed in 38.1% and 55% of patients, respectively. Multivariate analysis showed that invasive mechanical ventilation, proteinuria, HBA1c level, history of cardiovascular disease, and use of statins were independent risk factors for AKI development in patients with diabetes. Conclusion. Results of this study showed that AKI develops in a considerable percentage of patients with COVID-19, especially in those with diabetes, and is significantly associated with mortality

Clinical Characteristics of Fatal Cases of COVID-19 in Tabriz, Iran: An Analysis of 111 Patients

Introduction: The rapid worldwide spread, in addition to the morbidity and mortality associated with the novel coronavirus disease 2019 (COVID-19), have raised concern throughout the world. Identifying the characteristics of patients who died of COVID-19 is essential to implement preventive measures. Objective: We aimed at investigating these characteristics among the Iranian population in Tabriz. Methods: In this case series, we analyzed clinical characteristics, laboratory parameters, and imaging findings of 111 patients with a reverse transcriptase-polymerase chain reaction (RT-PCR)-confirmed COVID-19 diagnosis who died during hospitalization. The studied patients had been admitted to the hospital between February 2020 and May 2020. Results: The median age of patients was 73 years (IQR, 62-82 years) and approximately 70% of them were male. The median oxygen saturation on admission was 88% (IQR, 80-92%) and dyspnea, cough, and fever were the most common presenting symptoms. Among comorbidities, diabetes, hypertension, and cardiovascular diseases were more frequently observed among patients who had a fatal outcome. While ground-glass opacity was the most commonly reported finding on chest computed tomography, 5% of the patients had no abnormal finding on imaging. Chloroquine was the most frequently used medication for treatment. Conclusion: Our results showed that the majority of COVID-19 deaths occurred in male elderly with decreased levels of oxygen saturation and elevated levels of lactate dehydrogenase and erythrocyte sedimentation rate on admission