فهرست مطالب غلامعباس سبز

Managing pain and mental distress in cancer patients is one of the main priorities of care. Therefore, the aim of the present study was to determine and evaluate the effect of desensitization with eye movements and reprocessing on pain intensity in cancer patients with 24-month follow-up.

The present clinical trial study was conducted on cancer patients suffering from pain at Shahid Jalil Hospital, Yasuj, in 2019. A total of 60 patients were selected by convenience sampling and randomly divided into two groups of intervention and control based on the allocation of random blocks and in parallel. In the intervention group, the technique of desensitization with eye movements and reprocessing in 7 one-hour sessions daily (one session per day) was held individually in the counseling room. In the control group, no intervention was performed by the researcher and they received only routine hospital treatment and care. The severity of pain and mental distress of patients before the intervention, after the intervention and at 24-month follow-up in both groups was measured by the pain rating scale and the mental distress scale. The collected data were analyzed using descriptive statistics, Chi-square, independent t-test and analysis of variance using SPSS 24 software.

Analysis of variance with repeated measures disclosed that the mean pain intensity in the intervention group, before, after the intervention and at 24-month follow-up were 0.73±9.46, 1.51±3/03 and 1.23±5.66 respectively which had a statistically significant decrease (p<0.0001). Moreover, mental distress in patients in the intervention group before and after the intervention, and at 24-month follow-up, respectively; 0.56±9.76, 1.52±3.26 and 1.62±6.61 which had a statistically significant decrease(p<0.0001). In the control group, using repeated measures analysis of variance, the mean pain intensity and mental distress before, after, and 24-month follow-up were not statistically significant(p> 0.05).

The results indicated that the method of desensitization with eye movements and reprocessing was effective in reducing pain in cancer patients and its effect was still lasting after 24 months of follow-up. Therefore, it is recommended to use this new and effective method in reducing pain in cancer patients.

Otomycosis is a chronic, acute or subacute infection of the external auditory canal. Aspergillus and Candida species are the most common fungal agents of Otomycosis. Although Otomycosis rarely life-threatening, the disease is a challenging and frustrating entity for both patients and doctors as it requires long-term treatment and follow-up, despite this, there could be recurrences. Resistance in Aspergillus and Candida has been increasingly investigated and reported because of standards for susceptibility testing and associated breakpoints became available and as a consequence of the increased use of antifungal compounds. We aimed to determine the susseptibility of Amphotericin  B, Itraconazole, Voriconazole, and Clotrimazole on Aspergillusis strains isolated in Otomycosis patients referred toYasuj Shahid Mofatteh Clinic.

160 clinical species of Aspergillus spp, including 60 strains of A. flavus, 53 strains of A. Tubingensis, 43 strains of A. niger, 3 strains of A. terreus and 1 strain of A. fumigatus isolated from Otomycosis patient cultured on PDA medium and evaluated drug sensitivity of Amphotericin  B, Itraconazole, Voriconazole, and Clotrimazole according to the CLSI M38A2 guidelines

MIC50 and MIC90 of Amphotericin  B, Itraconazole, Voriconazole and Clotrimazole against A. flavus (1 and 2, 0.0156 and 0.0625, 0.125 and 0.25, 0.25 and 1), A. niger (2 and 4, 0.0625 and 0.25, 0.125 and 0.25, 0.5 and 1) and A. tubingensis (2 and 4, 0.125 and 0.5, 0.25 and 0.25, 1 and 1) were reported respectively. All strains of Aspergillus were sensitive to Itraconazole and Voriconazole.

The laboratory data obtained from this study showed that Itraconazole has the best antifungal effect against Aspergillus species, followed by Voriconazole, Clotrimazole and Amphotericin B, respectively. Itraconazole and Voriconazole appear to be alternative drugs for the treatment of Aspergillusis, but more studies are needed to investigate the resistance of different Aspergillus species to different antifungal drugs

Adenoid hypertrophy is one of the childhood complications in which bacteria are involved in its etiology. The aim of the present study was to determine the relative abundance of biofilms and genes associated with biofilm formation in Staphylococcus aureus isolates and also to determine the genotypic patterns of S. aureus isolates from adenoids and tonsils of children with adenoid hypertrophy by Spa typing method.

The present cross-sectional study was conducted on 86 pair isolates of S. aureus collected from adenoid and tonsil of children with adenoid hypertrophy. Phenotypic method used for assessing of biofilm production in S. aureus isolates and the presence of icaA,icaD,fnbA and clfA genes evaluated using polymerase chain reaction method. The spa typing method was apllied for typing of isolated. Data were analyzed using descriptive statistics method and SPSS software.

S. aureus isolated from adenoids and tonsils were positive in 49 (57%) and 40 (46.5%) biofilms, respectively. In 47 cases, pairs of isolates from the adenoids and tonsils were similar in terms of biofilm production. In the present study, 4 types of spa types were identified in S. aureus including t081 type, the most dominant type in 67.5%, t701 in 11.6%, t2419 in 9.3% and t4870 in 8.2% of adenoid isolates. In total, 79.45% of adenoid and tonsil isolates had similar typing. highest frequency of genes was related to fnbA, which was detected in adenoids in 64% and in tonsils in 41.9% of isolates.

Due to the relative frequency of biofilm formation, biofilm is of moderate importance in the establishment of Staphylococcus aureus in the tonsils and adenoids of patients. Moreover, the role of fnbA gene in biofilm formation was higher than other studied genes. High spa similarity Staphylococcus aureus isolates isolated from the adenoids and tonsils indicate the initial colonization of bacteria in the tonsils and then act as a source of infection for the adenoids.

Tooth occlusion is a common anomaly that is caused by several factors including local and systemic factors. The most common teeth that may be occluded are tertiary permanent teeth, maxillary canines, maxillary and mandibular premolars, and maxillary central incisors. The aim of the present study was to investigate the prevalence of occlusion of different teeth in patients referred to the Oral and Maxillofacial Radiology Clinic in Yasuj during 2017-2018

In this retrospective study, 2536 digital panoramic radiographs were studied among patients who were over 14 years old and referred to the Oral and Maxillofacial Radiology Clinic in Yasuj during the years 2016 to 2017. Patients with a history of trauma, developmental abnormalities, syndromic, pathological problems, and edentulousness were excluded. Radiographs were taken with the VATECH digital panoramic device (pax-i3D). The graphs were examined and a tooth was considered to be occluded, which was prevented from growing normally by a bone or a lateral tooth, as well as a tooth whose occlusal surface was visibly lower than the occlusal surface of adjacent teeth. Chi-square test was used to examine the relationship between age and type of impacted teeth and the difference between men and women in terms of impacted teeth.

Out of 2536 patients, the maxillary molar teeth (number=57) were 2.2%, mandibular molar teeth (number = 46) 1.8%, maxillary canine (number=39), 1.5%, maxillary premolars, respectively. Number=8) 30%, canine (number=7) 3% and incisor (number=4) was 4.2%, which had the most impacted teeth related to the maxillary molars and there were no mandibular premolars and mandibular incisors in this study. There was no significant difference between age and sex in terms of latency.

Dental occlusion in Yasuj city is not considered high, and the highest prevalence of occlusion is after maxillary molars, mandibular molars and maxillary canines. Therefore, if the canine teeth do not grow in time, radiography is recommended to examine their occlusion and use appropriate treatment.

Pain is the most common post-tonsillectomy complaint in children, whose insufficient relief can result in a number of complications. The present study aimed to determine and compare the effects of the local injection of bupivacaine and lidocaine-epinephrine mixture on post-tonsillectomy pain.

In this double-blind randomized clinical trial, 87 candidate children for tonsillectomy aged 4-10 years were selected through non-probability convenience sampling. The subjects were randomly assigned to 3 groups. All patients in the three groups underwent identical general anesthesia and cold knife dissection procedures. Five minutes before incision, children in the intervention groups received 2 mL of bupivacaine 0.125% and 2 mL of a mixture of lidocaine 1% and epinephrine (1:200,000), respectively, through tonsillar and peritonsillar local injection. Pain intensity was assessed 2, 4, 6, and 8 hours after surgery using the Wong-Baker Faces Pain Rating Scale. Data were analyzed in SPSS 21 using descriptive and inferential statistics at a 95% confidence interval and 0.05 significance level.

The postoperative pain intensity ranged from 4 to 8 in the bupivacaine-receiving group, from 5 to 8 in the lidocaine-epinephrine mixture-receiving group, and from 6 to 10 in the control group. A statistically significant difference was observed in the median pain intensity among the three groups of children participating in the study (p=0.001). Although the pain intensity in the bupivacaine-receiving children was lower than lidocaine-epinephrine mixture-receiving children 2, 4, 6, and 8 hours after surgery, the difference was only statistically significant 2 and 4 hours postoperatively (p=0.001) and no statistically significant difference was observed in other times (p>0.05). There was a significant difference in the pain intensity between the two intervention groups and the control group at all times (2, 4, 6, and 8 hours after surgery) (p=0.001).

Although local injection of bupivacaine and lidocaine-epinephrine mixture reduced post-tonsillectomy pain in children, there was no difference in their effect on pain reduction except 2 and 4 hours postoperatively.

Surgical procedures containing structures next to the mandibular canal need accurate knowledge of the intraosseous trajectory of this anatomical landmark to prevent iatrogenic injuries to this site.

In this study, CBCTs of 101 patients were evaluated and classified by sex, age and presence or absent of bifurcation. The type of bifurcation was identified using of classification of Langlais and Correr.

According to Langlais et al classification 50% of cases were type 1(1u) and 50% type 2(2uc) and based on Corer et al classification 2 cases were type B (20%) and 8 cases were type D (80%). BMC frequency was 9.9%.

BMC frequency was 9.9% that was significant. Also, in this study BMCSs was more frequent in females than males (P value was 0.04).

Fungal spores are present in large amounts in the nature which may cause diseases in the susceptible individuals. Fungal rhinosinusitis has been increased during recent decades. This study aims to investigate fungal rhinosinusitis in the patients with chronic needing endoscopic sinus surgery aims and to determine the sensitivity of the isolates to rhin sinusitis antifungal agents. In cross sectional study، specimens were obtained in sterile plates containing normal saline. from the suspected cases of chronic rhinosinusitis who had undergone endoscopic sinus surgery. Microscopic experiments and Cultures were done in Sabouraud Dextrose Agar medium. Minimum inhibitory concentration (MIC) of the growth of fungi for seven antifungal agents against the isolates was determined using E-Test. In total، specimens from 102 immunocompetent patients were examined. Nine positive specimens were presented، consisting of 3 for Aspergillus fumigatus، 3 for Penicillium، 2 for Aspergillus flavus and 1 for Alternaria. The mean age of the patients was 38 years، with 59 males and 43 females. The isolates were most sensitive to the voriconazole and amphotericin B. Since the prevalence of fungal rhinosinusitis is low، unfortunately، the clinicians are not attentive enough to the condition، and they initiate antifungal therapy if the patients are not responsive to antibiotics. Early diagnosis and suitable treatment can help more efficient management of patients.