A study of the etiology of referred Otalgia

Introduction: Otalgia is one of the complaints which may occur at any age. The etiology of the pain may be in the ear, structures around the ear or other head and neck structures. This is caused by the complex nervous connections in the head and neck areas, the ear, the pharynx and the nose. Since understanding the etiologies of referred otalgia can help in the assessment and treatment of the disease, this research was conducted to identify the etiologies of referred otalgia in patients visiting the ENT Clinic in Gorgan, Iran. Materials and Methods: This prospective research was conducted on patients who visited the ENT Clinic with an earache, but in initial assessments the ear was normal. Patients' data consisting of sex, age, complaint, the inflicted side, physical findings in the ear, the nose, the throat and head and neck were recorded in a questionnaire. These data were then analyzed with SPSS software. Results: Of 770 patients with otalgia, 94 patients (12.2%) had referred otalgia. Of these patients 27.7% were men and 72.3% were women. The most common etiology of referred otalgia was dental problems (62.8%), and one patient who was being treated for pharyngitis had carcinoma of the base of the tongue. In 47.8% of cases the pain was in the left ear, in 43.4% in the right ear, and in 8.7% it was bilateral. Conclusion: In view of the fact that a significant proportion of the patients who complained of otalgia had no pathologies in the ear, thorough physical examination in adjacent structures especially teeth should be performed and malignancies should be considered as a possible etiology of otalgia

The comparison of hearing loss among diabetic and non-diabetic patients

Introduction: The prevalence of Diabetes Mellitus is steadily increasing. This is a multi- systemic abnormality, causing side- effects which are mainly irreversible. Hearing loss is one of the common symptoms, and there are many studies, with contradictory results. Aim of this study was to compare the hearing loss among diabetic with non- diabetic patients. Material and Methods: In this study 50 diabetic patients were chosen randomly from those overt diabetic patients referred to the Diabetes clinic in Gorgan hospital northern Iran, 50 other patients who referred to the 5th Azar hospital, with any other ENT complaint were also randomly chosen as control group. The case and control groups were matched. Demographic questionnaires were filled for each subjects in case and control groups, and those with intervening factors were omitted from this study. Data were analyzed using SPSS. Results: In this study 66% and 34% of participants were men and women respectively. The age distribution of the patient were 15-75 years. The hearing loss among diabetic patients and non- diabetic subjects were 16% and 5% respectively, which showed that the diabetic patient has3.2 times more possibility to acquire hearing problem. It was also shown, that there was a direct correlation between increasingage and hearing loss. More women are at risk, of getting hearingloss than men. The hearing loss also has a correlation with the duration of disease onset and the consumption of Glibanclamid. Conclusion The careful periodical assessment of hearing loss, and the application of hearing facilities to improve the qualityof diabetic patients life is recommended due to chronic and irreversible Symptom of the disease

Relative Fractional Packing Number and Its Properties

The concept of the \textit{relative fractional packing number} between two graphs $G$ and $H$, initially introduced in arXiv:2307.06155 [math.CO], serves as an upper bound for the ratio of the zero-error Shannon capacity of these graphs. Defined as: \begin{equation*} \sup\limits_{W} \frac{\alpha(G \boxtimes W)}{\alpha(H \boxtimes W)} \end{equation*} where the supremum is computed over all arbitrary graphs and $\boxtimes$ denotes the strong product of graphs. This article delves into various critical theorems regarding the computation of this number. Specifically, we address its NP-hardness and the complexity of approximating it. Furthermore, we develop a conjecture for necessary and sufficient conditions for this number to be less than one. We also validate this conjecture for specific graph families. Additionally, we present miscellaneous concepts and introduce a generalized version of the independence number that gives insights that could significantly contribute to the study of the relative fractional packing number

Cytoprotective effects of melatonin against amitriptyline-induced toxicity in isolated rat hepatocytes

Purpose: Amitriptyline, one of the commonly used tricyclic antidepressants, caused rare but severe hepatotoxicity in patients who received it continuously. Previous findings showed that the intermediate metabolites of amitriptyline produced by CYP450 are involved in hepatic injury. Melatonin is an antiaging and antioxidant hormone synthesized from pineal gland. The aim of present study was to evaluate the protective role of melatonin in an in vitro model of isolated rat hepatocytes. Methods: Markers such as cell viability, reactive oxygen species formation, lipid peroxidation, mitochondrial membrane potential, and hepatocytes glutathione content were evaluated every 60 minutes for 180 minutes. Results: Present results indicated that administration of 1mM of melatonin effectively reduced the cell death, ROS formation and lipid peroxidation, mitochondrial membrane potential collapse, and reduced cellular glutathione content caused by amitriptyline. Conclusion: Our results indicated that melatonin is an effective antioxidant in preventing amitriptyline-induced hepatotoxicity. We recommend further in vivo animal and clinical trial studies on the hepatoprotective effects of melatonin in patients receiving amitriptyline. © 2015 The Authors

Risk factors for sensorineural hearing loss among high-risk infants in Golestan province, Iran in 2010 - 2011

Background: Hearing impairment, as one of the most common birth defects, is a hidden disability with negative impacts on speech and cognitive development. Objectives: The aim of this study was to assess the prevalence of sensorineural hearing loss (SNHL) and determine the associated risk factors among infants admitted to neonatal intensive care units (NICUs) and neonatal wards of teaching hospitals, affiliated to Golestan University of Medical Sciences, Gorgan, Iran. Patients and Methods: In this cross-sectional study, 791 infants were recruited via non-random sampling. Demographic and clinical characteristics of the subjects were gathered, and the Automated Auditory Brainstem Response (AABR) test was performed upon admission. Afterwards, the subjects were followed-up and re-assessed, using the AABR test. For infants with abnormal AABR results, the Auditory Brainstem Response (ABR) test was performed on the day of discharge. Results: The mean age of the infants was 3.75 ± 4.86 days upon admission, and 56.4% of the subjects were female. The mean length of hospital stay was 9.63 ± 1.1 days; the subjects were hospitalized for 3.50 ± 10.21 days in the NICUs and 6.1 ± 5.27 days in the neonatal wards. In total, 3.4% of the infants presented with SNHL. No significant difference was found between SNHL and neonates’ age (P = 0.52), sex (P = 0.5), or sepsis (P = 0.94). However, SNHL was significantly associated with gestational age (P = 0.045), birth weight (P < 0.001), length of hospital stay (P < 0.001), pathological jaundice (P=0.033), antibiotic treatments (P = 0.007), and total serum bilirubin level (P = 0.01). Additionally, binary logistic regression analysis demonstrated the association between SNHL and these factors. Conclusions: In this study, the prevalence of SNHL among hospitalized neonates was similar to previous reports in Iran and other countries. Based on the findings, administration of ototoxic drugs during the neonatal period can lead to SNHL. Therefore, it seems essential to regularly screen newborns under treatment and limit the indiscriminate use of ototoxic drugs. © 2015, Iranian Red Crescent Medical Journal

Is opioid dependency related to coping strategies?

Using opioid for recreational purposes has a very long history in Iran. Social influence is a useful framework in understanding how the social environment affects the individual's behavioral choices to use drugs. We compared opioid dependents (n=149) with controls (n=221) on measures of coping strategies using the Jalowiec Coping Scale and some socioeconomic factors. The differences in 10 of 15 coping strategies were significant in the study groups (P<0.05). Although, the combined score of problem-oriented and affective-oriented items did not show any significant difference between the two groups. There was a significant relation between opioid dependence with smoking cigarettes (P<0.001), lower education (P=0.002), being employed (P<0.001), having children (P<0.001), and being married (P<0.001). Educational programs to improve problem solving and coping skills can be helpful to reduce the rate of dependency to opioid and smoking cigarettes. © 2015, Sadeghali Taziki, et al

Comparing the Effect of Vitamin E and N-Acetylcysteine on Prevention of Contrast-Induced Nephropathy in Diabetic Patients under Coronary Angiography

Introduction:&nbsp; Considering the incidence of contrast&nbsp; induced&nbsp; nephropathy&nbsp; (CIN) as well as&nbsp; its&nbsp; complications&nbsp; and&nbsp;&nbsp;&nbsp; costs,&nbsp; prevention&nbsp; and&nbsp; reducing&nbsp; the&nbsp; risk&nbsp; of&nbsp; CIN&nbsp; is&nbsp; an&nbsp; essential&nbsp; issue.&nbsp; The&nbsp; present&nbsp; study&nbsp; aimed&nbsp; to&nbsp; evaluate&nbsp; the&nbsp; efficacy&nbsp; of&nbsp; vitamin&nbsp; E&nbsp; and&nbsp; N-acetylcysteine&nbsp; (NAC)&nbsp; on the prevention&nbsp; of&nbsp; CIN&nbsp; in&nbsp; diabetic&nbsp; patients&nbsp; undergoing&nbsp; coronary&nbsp; angiography. Materials and Methods:&nbsp; 360&nbsp; patients&nbsp; with&nbsp; diabetes&nbsp; who&nbsp; required&nbsp; angiography,&nbsp; including&nbsp; patients&nbsp; with&nbsp; stable&nbsp; angina&nbsp; susceptible&nbsp; to&nbsp; acute&nbsp; myocardial&nbsp; infarction&nbsp; and&nbsp; patients&nbsp; with&nbsp; acute&nbsp; coronary&nbsp; syndrome&nbsp; were&nbsp; included&nbsp; and&nbsp; randomized&nbsp; into&nbsp; three&nbsp; groups .&nbsp; Group&nbsp; 1&nbsp; received&nbsp; serum&nbsp; therapy&nbsp; (Normal Saline)&nbsp; plus&nbsp; NAC&nbsp; and&nbsp; placebo&nbsp; of&nbsp; vitamin&nbsp; E,&nbsp; group&nbsp; 2&nbsp; received&nbsp; serum&nbsp; therapy&nbsp; plus&nbsp; vitamin&nbsp; E&nbsp; and&nbsp; placebo&nbsp; of&nbsp; NAC,&nbsp; and&nbsp; group&nbsp; 3&nbsp; only&nbsp; received&nbsp; serum&nbsp; therapy&nbsp; with&nbsp; two&nbsp; placebos&nbsp; of&nbsp; NAC&nbsp; and&nbsp; vitamin&nbsp; E.&nbsp; The groups were compared considering CIN after angiography. Results:&nbsp; A&nbsp; total&nbsp; of&nbsp; 93&nbsp; patients&nbsp; were&nbsp; studied&nbsp; in&nbsp; group&nbsp; 1,&nbsp; 94&nbsp; in&nbsp; group&nbsp; 2,&nbsp; and&nbsp; 113&nbsp; in&nbsp; group&nbsp; 3.&nbsp; CIN&nbsp; occurred&nbsp; in&nbsp; 4&nbsp; patients&nbsp; (4.3%),&nbsp; 4&nbsp; patients&nbsp; (4.3%),&nbsp; and&nbsp; 8&nbsp; patients&nbsp; (7.1%)&nbsp; in&nbsp; groups&nbsp; 1,&nbsp; 2,&nbsp; and&nbsp; 3,&nbsp; respectively&nbsp; (P=0.58).&nbsp; There was&nbsp; a&nbsp; significant&nbsp; difference&nbsp; in&nbsp; mean&nbsp; difference&nbsp; of&nbsp; creatinine&nbsp; levels&nbsp; before&nbsp; and&nbsp; after&nbsp; study&nbsp; in&nbsp; groups&nbsp; 1&nbsp; and&nbsp; 2&nbsp; (both&nbsp; P&lt;0.001).&nbsp; In&nbsp; the&nbsp; subgroup&nbsp; of&nbsp; patients&nbsp; with&nbsp; chronic&nbsp; kidney&nbsp; disease,&nbsp; NAC&nbsp; significantly&nbsp; reduced&nbsp; CIN&nbsp; (P=0.03). Conclusion:&nbsp; The results&nbsp; suggested&nbsp; efficacy&nbsp; of&nbsp; both&nbsp; interventions,&nbsp; considering&nbsp; reduction&nbsp; of&nbsp; mean&nbsp; Serum creatinine ( Scr) after&nbsp; the&nbsp; study,&nbsp; while&nbsp; lack&nbsp; of&nbsp; significant&nbsp; difference&nbsp; in&nbsp; the&nbsp; incidence&nbsp; of&nbsp; CIN&nbsp; could&nbsp; be&nbsp; because&nbsp; of&nbsp; the&nbsp; low&nbsp; number&nbsp; of&nbsp; CIN&nbsp; in&nbsp; our&nbsp; study.&nbsp; The second&nbsp; important&nbsp; finding&nbsp; of&nbsp; this&nbsp; study,&nbsp; probably the&nbsp; reduced&nbsp; risk&nbsp; of&nbsp; CIN&nbsp; in&nbsp; diabetic&nbsp; patients&nbsp; with&nbsp; chronic&nbsp; kidney&nbsp; disease&nbsp; receiving&nbsp; NAC,&nbsp; recommends&nbsp; the&nbsp; use&nbsp; of&nbsp; NAC&nbsp; for&nbsp; prevention&nbsp; of&nbsp; CIN,&nbsp; especially&nbsp; in&nbsp; this&nbsp; subgroup&nbsp; of&nbsp; patients&nbsp; undergoing&nbsp; angiography

Evaluation of amitriptyline-induced toxicity in freshly isolated rat hepatocytes and the protective role of taurine&quot;

Abstract: Administration of amitriptyline, a most commonly used tricyclic antidepressant, is associated with anticholinergic side effects and rare but severe hepatotoxicity. It supposed that the intermediated metabolites of amitriptyline produced by CYP450 involved in hepatotoxicity but the exact mechanisms involved in hepatotoxicity are unknown. The aim of this study was to determine the mechanism of hepatotoxicity induced by amitriptyline and protective role of taurine in an in vitro model of isolated rat hepatocytes. Markers such as cell viability, reactive oxygen species (ROS) formation, lipid peroxidation, mitochondrial membrane potential, and hepatocytes glutathione content were evaluated every 60 minutes for 180 minutes. Our results showed that amitriptyline resulted in cytotoxicity characterized by the reduction in cell viability, an increase in ROS formation and lipid peroxidation, mitochondrial membrane potential collapse, and a reduction in cellular glutathione content. Our finding showed administration of taurine (1mM) effectively reduced the toxic effects of amitriptyline in isolated rat hepatocytes