Clinical evaluation of safety and complications of the nasal tip defatting in rhinoplasty

Objective: Nasal tip refinement is an important objective in aesthetic rhinoplasty and one of the surgical options for soft tissue management in very thick bulbous skin and subcutaneous noses is tip defatting. The aim of this study was to evaluate the safety and complications of tip defatting in thick skin and bulbous noses.  Methods: Among 527 patients that underwent rhinoplasty in Modaress hospital between February 2011 and January 2014, nasal tip defatting were performed in 162 of these patients. Intraoperatively and in follow up examinations, any signs of skin congestion, ischemia, hematoma, and skin quality evaluated.  Results: Among 162 patients who had performed tip defatting [39 (24.1%) male patients and 123 (75.9%) female], complications were skin congestion in 6 patients (3.7%), ecchymosis in 10 patient (6.1%). There were no cases of skin necrosis, skin perforations or skin irregularity.  Conclusion: Our study and many previous studies show that tip defatting in association with lower lateral cartilage reduction is a safe and helpful method in correction of bulbous nose deformity

Chronic nonpigmented Villonodular synovitis in a 13 years old girl: A case report

Nonpigmented villonodular synovitis is a very uncommon and benign proliferative disorder involving the synovium. It is mostly seen in the knee. Here we present a 13-year old girl with a 2 year history of left wrist mass without any pain, tenderness or limitation in range of motion. We believe it is necessary to considere villonodular synovitis in a child with chronic joint effusion as a differential diagnosis

A theory of planned behavior-enhanced intervention to promote health literacy and self-care behaviors of type 2 diabetic patients

Abstract Background: Improved health literacy and awareness could help type 2 diabetic patients to control the disease complications. Objective: The current study aimed to evaluate the impact of theory-based educational intervention on health literacy and self-care behaviors of type 2 diabetic patients in Tonekabon city. Methods: This randomized controlled trial study was conducted at health care centers in Tonekabon city, Iran, from April 5, 2017, to October 22, 2018. Using multistage random sampling, 166 patients with type 2 diabetes divided into two groups: theory-based intervention (n = 83) and custom education (n = 83). The data collection tools consisted of demographic information, Theory of Planned Behavior (TPB) measures, health literacy for Iranian adults (HELIA) and summary of diabetes self-care activities (SDSCA). The five 45-minute group training sessions based on the baseline assessment and model constructs along with the targeted pamphlet and m-health strategy were designed for the experimental group. Data were analyzed using chi-square, independent and paired t-test and Analysis of covariance (ANCOVA). Results: After controlling for pre-test effect, there was a significant difference between the two groups in terms of mean scores of attitudes, subjective norms, perceived behavior control and intention in post-test (P < 0.001). Also, after controlling for the pre-test effect, the results showed a significant difference in the self-care domain in the post-test (P < 0.001). Finally, after controlling for the pre-test variable effect, covariance analysis reflects significant difference in total health literacy score and its dimension at posttest (P < 0.001). Conclusions: Applying TPB based education is suggested to maintain and improve self-care behaviors and health literacy in type 2 diabetic patients and other chronic diseases. Keywords: Attitude; Behavior change; Diabetes; Health literacy; Self-care behavior

Nasal packing, periorbital edema and ecchymosis after septorhinoplasty

Introduction:Edema and ecchymosis after septorhinoplasty is an unpleasant manifestation for both the patient and surgeon. Although routine nasal packing is frequently done after septorhinoplasty, assessing the relevancy of post-surgical periorbital edema and ecchymosis with nasal packing eventually may helps to clarifying more prohibitable causes of these complications that are unintentionally perform. Materials and Methods: In an interval of 1.5 years, 124 patients whom were candidates of septorhinoplasty by one surgeon in a center of plastic and reconstructive surgery in Tehran participated in our study. Patients were randomly divided in two groups. For half of them at the end of operation bilateral routine nasal packing was done and for the rest a light dressing limited to the nostril was performed. Thereafter, sequentially in the 1st, 3rd, 7th and 30th postoperative day severity of periorbital edema and ecchymosis were recorded based on a scaling system by a third person who was not informed about the study. Results: Conventional nasal packing is relevant to an increasing number of cases with periorbital edema and ecchymosis after septorhinoplasty. The difference between patients whom were nasally packed or not was not significant at the first postoperative day but in the 3rd and 7th day it was meaningfully less in number and severity in the unpacked group. Discussion: This shows that it is not necessary to do pack in every patient after septorhinoplasty and performing a light dressing may suffice.

A bizarre presentation of Peutz – jegher’s syndrome in a 2 year old

Peutz - jegher’s syndrome (PJS) is a rare autosomal dominant disorder with gastro intestinal and mucosal pigmentations. We present a 2 y/o boy with a lesion prolapsing from his rectum that could not be reducted. We found him to have PJS and a familial history of PJS in his parents

Evaluation of Staggered Osteotomy in Surgical Treatment of Trigonocephaly

Introduction: undiagnosed metopic synostosis (Trigonocephaly) have many complications for infants such as Brain damage and cognitive &amp; behavioral disorders, they also result in poor aesthetic features. There are many surgical techniques for this malformation which have their advantages and disadvantages; but with this new method (staggered osteotomy) we can solve some of these problems and minimize damages.Materials and Methods:  In this study, 20 infants with metopic synostosis underwent surgery in Mofid Children Hospital, Tehran.  The minimum age of our patients was 4 months and the maximum was 9 months with an average of 6.72 months. Their diagnosis was confirmed with clinical symptoms &amp; signs also with CTscan and paraclinical findings. Age and weight before and after surgery and anthropometric indices including: biparietal width and frontal width were recorded and reported.Results: We found significant differences in anthropometric indices before &amp; after surgery such as lowering of biparietal width after surgery and elevation of frontoparital index after surgery. Since in this procedure, we don’t separate the frontal bone segments and it keeps its frame, less plaques and screws are needed which will decrease the costs of surgery and the surgical time is much less than other techniques. Last but not the least, the satisfactions of parents were high and there was no need for secondary surgery.Conclusion:Based on all the perfect results we got , it is safe to say that staggered osteotomy as a surgical method for correction of trigonocephaly is useful and we can use it as a new method in correction of  metopic synostosis

BCL11B Is Involved in Stress-Induced Differentiation of Keratinocytes and Has A Potential Role in Psoriasis Pathogenesis

Objective: Psoriasis is a common, auto-immune skin disease characterized by abnormal proliferation and differentiationof keratinocytes. Studies revealed the role of stress stimulators in the pathogenesis of psoriasis. Oxidative stressand heat shock are two important stress factors tuning differentiation and proliferation of keratinocytes, regardingto psoriasis disease. BCL11B is a transcription factor with critical role in embryonic keratinocyte differentiation andproliferation. Given this, in keratinocytes we have investigated potential role of BCL11B in stress-induced differentiation.Furthermore, we searched for a potential intercommunication between BCL11B expression and psoriasis-relatedkeratinocyte stress factors.Materials and Methods: In this experimental study, data sets of psoriatic and healthy skin samples were downloadedin silico and BCL11B was chosen as a potential transcription factor to analyze. Next, a synchronized in vitro model wasdesigned for keratinocyte proliferation and differentiation. Oxidative stress and heat shock treatments were employed onHaCaT keratinocytes in culture, and BCL11B expression level was measured. Cell proliferation rate and differentiationwere analyzed by synchronized procedure test. Flow cytometry was done to analyze cell cycle alterations due to theoxidative stress.Results: Quantitative reverse transcription polymerase chain reaction (qRT-PCR) data revealed a significantupregulation of BCL11B expression in keratinocytes, by 24 hours after initiating differentiation. However, it was followedby a significant down-regulation in almost all the experiments, including the synchronized model. Flow cytometer datademonstrated a G1 cell cycle arrest in the treated cells.Conclusion: Results indicated a remarkable role of BCL11B in differentiation and proliferation of HaCaT keratinocytes.This data along with the results of flow cytometer suggested a probable role for BCL11B in stress-induced differentiation,which is similar to what is happening during initiation and progression of normal differentiation

Prevalence of Surgical Site Infection After Hip Arthroplasty; a Systematic Review and Meta-Analysis

Introduction: One of the worrisome complications of hip arthroplasty is surgical site infection (SSI). This study aimed to investigate the prevalence of SSI after hip arthroplasty. Methods: A comprehensive and systematic exploration was conducted across various international electronic databases, including Scopus, PubMed, and Web of Science, alongside Persian electronic databases such as Iranmedex and the Scientific Information Database (SID). This search strategy entailed the utilization of Medical Subject Headings-derived keywords such as "Prevalence," "Surgical wound infection," "Surgical site infection," and "Arthroplasty," spanning from the earliest records up to January 1, 2024. Each study’s weight was assigned based on its inverse variance. A forest plot visualization was used to assess the studies’ heterogeneity. Data on sample size and SSI frequency were compiled for each study to calculate the overall effect size. Results: The study encompassed a cumulative participant cohort of 1,070,638 hip arthroplasty procedures drawn from seventeen selected studies. Notably, the female gender constituted 59.10% of the overall participant demographic. The aggregate SSI among patients undergoing hip arthroplasty was estimated to be 1.9% (95% CI: 1.3% to 2.8%; I2=99.688%; P<0.001). The results of the meta-regression analysis unveiled a statistically significant correlation between the prevalence of SSIs after hip arthroplasty and the year of publication (Coefficient=-0.0020; 95% CI: -0.0021 to -0.0018; Z=-19.39, P<0.001). Conclusion: The study findings indicated a prevalence rate of 1.9% for SSI following hip arthroplasty. This prevalence underscores the importance of vigilance in infection prevention and management strategies within orthopedic surgery. However, it is essential to acknowledge the variability in SSI prevalence observed across diverse studies, which can be attributed to multifaceted factors, notably variances in patient populations and associated risk factors

A theory of planned behavior-enhanced intervention to promote health literacy and self-care behaviors of type 2 diabetic patients

Background. Improved health literacy and awareness could help type 2 diabetic patients to control the disease complications. Objective. The current study aimed to evaluate the impact of theory-based educational intervention on health literacy and self-care behaviors of type 2 diabetic patients in Tonekabon city. Methods. This randomized controlled trial study was conducted at health care centers in Tonekabon city, Iran, from April 5, 2017, to October 22, 2018. Using multistage random sampling, 166 patients with type 2 diabetes divided into two groups: theory-based intervention (n = 83) and custom education (n = 83). The data collection tools consisted of demographic information, The-ory of Planned Behavior (TPB) measures, health literacy for Ira-nian adults (HELIA) and summary of diabetes self-care activities (SDSCA). The five 45-minute group training sessions based on the baseline assessment and model constructs along with the targeted pamphlet and m-health strategy were designed for the experimen-tal group. Data were analyzed using chi-square, independent and paired t-test and Analysis of covariance (ANCOVA). Results. After controlling for pre-test effect, there was a signifi-cant difference between the two groups in terms of mean scores of attitudes, subjective norms, perceived behavior control and inten-tion in post-test (P < 0.001). Also, after controlling for the pre-test effect, the results showed a significant difference in the self-care domain in the post-test (P < 0.001). Finally, after controlling for the pre-test variable effect, covariance analysis reflects signifi-cant difference in total health literacy score and its dimension at posttest (P < 0.001). Conclusions. Applying TPB based education is suggested to maintain and improve self-care behaviors and health literacy in type 2 diabetic patients and other chronic disease

The Effectiveness of Coping Strategies Training on Knowledge, Pain Specific Self-efficacy and Related Indices with Migraine Headaches

Introduction and purpose: It has been proven that coping strategies and cognitive-behavioral techniques exert a positive impact on the improvement of negative emotions and the promotion of physical and mental health of patients with chronic headaches. The present study aimed to determine the effect of pain coping skills training interventions on knowledge, pain-specific self-efficacy, and the indices related to migraine headaches. Methods: This randomized controlled trial was conducted on 60 patients with migraine headaches referring to specialized clinics in Anzali. They were assigned to experimental and control groups using randomized sampling. Data were collected using a demographic and personal questionnaire, Coping Strategies Questionnaire, Pain specific Self-efficacy Questionnaire (PSEQ), and Knowledge Scale before and two months after the intervention. The educational intervention for the experimental group consisted of five 60-minute sessions, which was conducted in groups of 8-10 people. Chi-square test, independent and paired t-test, as well as one way ANOVA, were used for data analysis. Results: The obtained results were indicative of a significant increase in the mean score of knowledge and self-efficacy in the experimental group after the intervention (P<0.001). Moreover, the mean of frequency, severity, and duration of migraine headaches in the experimental group significantly decreased after the intervention (P<0.05). In addition, except for positive re-evaluation strategy, the mean frequency of using coping strategies significantly increased in the experimental group after the training (P<0.05). Conclusion: It is recommended that specialized physicians and therapists provide intervention based on chronic pain strategies along with treatment protocols to control chronic headaches and improve the quality of life of patients with migraine headache