ali eftekharian

 Acute mastoiditis is one of the complications of acute otitis media in children. Patients with acute mastoiditis commonly have manifestations of acute otitis media and inflammation of the mastoid bone. Computed tomography is the most frequent diagnostic method for diagnosing acute mastoiditis. In this report, we presented a 6-year-old boy with a history of cochlear implantation three years ago, who was referred for acute swelling and pain in the mastoid bone one day ago. 

 A 6-year-old boy with fever, pain, redness, and swelling of the posterior side of his right ear from one day ago was referred to the clinic. Physical examination showed tenderness, redness, warmness, and swelling on the right auricle and mastoid bone. Implantation in the right ear about three years ago was mentioned. Last week, involvement with coryza, nasal congestion, and low-grade fever without ear pain was mentioned. Acute mastoiditis was confirmed with CT scanning, and he was cured with antibiotic therapy.

 Acute mastoiditis is not common. It may occur after a few times of cochlear implantation, but it occurs rarely after a long time. The main cause is bacterial infection. After confirmation of the diagnosis with CT scanning, treatment with antibiotics should be started intravenously, and then it can be changed to oral antibiotics.    

 Acute mastoiditis should be considered as a differential diagnosis in pediatrics with acute swelling, pain, and any manifestation of inflammation on mastoid bone, even though there is no history of acute otitis media.

In order to decrease medical errors and improve organized, targeted education pre- and post-graduation, we intended to detect 10 most important concepts that neuro-otologists believe family physicians and general practitioners must know. A multi-center study based on Delphi’s method was designed and conducted in three stages. Of 31 topics gathered by expert panel, 10 top priorities were ranked based on 50 neuro-otologists’ opinion over the country. Early diagnosis and management of sudden sensorineural hearing loss, foreign body removal from external ear canal, proper management of otitis extern, and management of emergency situations in chronic otitis media gained the highest scores among all. Also, some topics, such as managing serous and acute otitis media, differentiating peripheral vs. central vertigos, and early hearing screening at birth were among top topics, contrary to others, such as surgery in only hearing ears, or hearing losses after COM surgeries. Almost all of the top-ranked topics are among critical/organ saving, or most prevalent medical concerns in all of the world. Sudden deafness, complicated COM, and mis-diagnosing vertigo may be organ/life threatening, while foreign bodies or inflammations of external ear, acute or serous otitis media, and congenital hearing loss are among the most prevalent medical problems worldwide, with numerous malpractices in their diagnosis and management. Regarding educational and practical priorities should be considered a basic step in neurotology field, and targeted programming policies.

As a result of the COVID-19 pandemic, many vaccines were developed to counter the disease, including the vector-based Sputnik V vaccine. This study aims to identify the side effects of the Sputnik V COVID–19 vaccine in a medical center and compare the results with the previous reports.

A questionnaire-based study was performed after the injection of the first and second doses of the vaccine to assess the side effects experienced by the participants. It was performed by reviewing similar previous studies.

Injection site pain, muscle pain, fever, fatigue, chills, and headache were the most common side effects of the vaccine. The incidence of major side effects decreased with age and was lower in men. In our study and others, the incidence of side effects was decreased in the second dose. In some studies, participants with a previous history of Severe Acute Respiratory Syndrome Coronavirus 2 (SARSCOV-2) infection developed more side effects, especially injection site pain, muscle pain, and fatigue.

Most studies agree with our reported results. Serious side effects of this vaccine are rare and may be considered tolerable in adults

Chronic otitis media is characterized by the accumulation of fluid in the middle ear and behind the tympanic membrane without signs of acute infection. The association between a middle ear infection and anatomical and physiological disorders of the Eustachian tube has been reported in several studies and its malfunction is one of the main causes of middle ear infection.

We aim to find the relation betweentubotympanic angle of theEustachian tube and chronicotitis media.

In this study, 100 patients with chronic unilateral middle ear infections were included. To determine the tubotympanic angle of the Eustachian tube, a temporal bone CT scan was used in the radiology department of Loghman Hospital. Eustachian tube angle andear function were recorded.

Among the 100 patients in the study, 42 were men and 58 were women. The mean age of patients in the study was 39.64±12.64 years. The angle was 3.79 ± 34.27 in the healthy ear and 2.43 ± 31.06 in the diseased ear, which showed a statistically significant difference between the two groups.

Eustachian tube angles in adults may play an important role in the cause of chronic otitis media. In this study, it was found that the horizontalization of the Eustachian tube is associated with chronic otitis media. Besides, determining the angle of the Eustachian tube can help determine the susceptibility to otitis media.

Hearing loss, especially at a young age, has severe personal and social consequences for a person and brings enormous costs to the treatment system. Considering the vital role of genetics in hearing loss, genetics research creates a suitable platform for progress in the treatment of these patients, so we decided to conduct a study with the aim of early diagnosis and even before symptoms appear in order to reduce possible complications.

In this study early diagnosis of hearing loss and even before symptoms appear in order to reduce possible complications.

Based on the history and phenotype and examination of the medical records of 1249 patients who are candidates for cochlear implantation, genetic testing among the patients suspected of non-syndromic genetic hearing loss, a request for genetic testing of stage one or two or both was made and according to the willingness of the families and their cooperation A total of 138 genetic tests were performed and subjected to genetic analysis.

Among 138 tested cases, 71 women and 67 men, NSHL inheritance autosomal recessive pattern was 84/78% and autosomal dominant, 5/07 which is very close to previous studies. There were genetic mutations in the Gjb2 gene in ten cases of patients. Ninety-one patients were negative for GJB2 involvement and were candidates for WES, but unfortunately, many families refused to perform the test due to the cost of this test. Seven patients underwent WES, and several genetic mutations were identified in the thesis. WES was performed for 34 patients according to the investigations carried out directly.

Iranian society has played an essential role in improving our understanding of the genes involved in proper hearing functioning and how these genes' variants cause hearing loss. Researchers have worked tirelessly to solve the genetic mystery of hearing loss in Iran, which has been very successful. However, more work is still needed.

We aimed to evaluate Iran's current COVID-19 infection, emphasizing the number of infection detection and the disease's reproductive number in its high peak in November and after the lockdown in December.

Using the Johns Hopkins Bloomberg School of Public Health Contact Tracing Evaluation and Strategic Support Application, we used the average weekly new cases and average case mortality in November and December 2020. The average case isolation and identification time (25%, Four days) and the average case contact within the household and community were entered into the application. We examined Two modeling systems with 50% and 70% case isolation for the November period as alternative scenarios for the current infection control rate.

Our modeling showed only 11% and 30% of the infections were detected in November and December. The disease's reproductive number is similar to the natural reproductive number of the disease (2-3) in November. The two models used to increase the rate of case isolation to 50% and 70% did not significantly change the reproductive number.

The priority in Iran for COVID-19 infection control should be a dramatic increase in the number of testing to achieve the correct number of case detection and fulfill the contact tracing criteria to reduce the disease spread.

Hereditary hearing loss (HHL) comprises half of the congenital deafness which arises from genetic mutations. Mutations in the TJP2 gene, encoding tight junction protein 2, are one of the gene alterations in HHL resulting in an autosomal dominant nonsyndromic form of the disease. An 11-year-old male patient with clinically approved congenital hearing loss was referred to our laboratory. The molecular genetic analysis detected an atypical heterozygous variant -c.1012G > C, p.G338R in exon 5 of the TJP2 gene on chromosome 9 position 71836379 (GRch37). Segregation analysis for his parents has uncovered the same mutation in the patient’s mother, but without any deafness phenotype. This case report provided evidence to demonstrate for the first time the incomplete penetrance of this TJP2 mutation and proposed this mutation as a “likely pathogenic” variant in an Iranian pedigree.

cancer invasion and lymphatic metastasis. Smoking has been reported to increase the metalloproteinase level, but the role of opium consumption in metalloproteinase level has not yet been examined. The current research intended to examine the impacts of opium consumption on the serum levels of metalloproteinase.
This case-control research was conducted in Kerman (in the southeast of Iran), after getting medical approve by the ethics committee. Case group of 33 non-smokers with no active inflammatory diseases who had the experience of inhaled opium and its derivatives were compared with a control group of 40 non-smokers with no active inflammatory disease and no experience of inhaled opium and its derivatives. Student’s t-test, mean, and chi-square test were employed to determine the correlation between the variables.
Findings: No statistically meaningful variation was detected in plasma metalloproteinase concentration between the case and control groups (P = 0.160). Also, there was no significant relation between the plasma metalloproteinase concentration and urinary morphine in case groups (P = 0.410), but a statistically significant correlation was found between gender and metalloproteinase in both the case and control groups (P = 0.003).

The aim of present study was evaluation of saccule function in cochlear implant candidates with severe to profound sensory neural hearing loss Before and after cochlear implantation.
In this study 35 cochlear implant (CI) candidates with bilateral severe to profound sensory neural hearing loss before and about 30 days after cochlear implant and 20 normal-hearing cases as a control group underwent VEMP test. Both groups were matched based on gender and age.
VEMP responses were absent bilaterally in 10 out of 35 patients. 4 patients were excluded from the study because they did not receive CI during present study. From 21 remaining patients, 5 cases lost VEMP responses in their implanted ear after surgery. In control group, VEMP responses were present bilaterally.
The results of present study indicate that saccule dysfunction in CI candidates is extremely probable and this is possible that saccule get impaired after CI.

Otitis media with effusion (OME) is one of the main sources of hearing impairment in children. One of the possible causes of middle ear infection and OME is immune system disorders. Based on previous studies, vitamin D deficiency plays an important role in the incidence of middle ear infections. This study aimed to determine blood levels of vitamin D in children with OME (as an inflammation of the middle ear) in comparison to a control group of patients admitted to Loghman-Hakim hospital in Tehran.Patients and In this case-control study, one hundred twenty children with OME who were admitted to Loghman-Hakim hospital between April 2013 and March 2014 and who were candidates for adenotonsillectomy were studied. They were divided into two groups based on tympanometry. The first group contained patients with OME and hearing loss of Type B or Type C2, and the second group (control) contained patients without OME and tympanometry of Type A or Type C2. On the day of surgery, blood samples were obtained for measurement and comparing of serum levels of vitamin D in the two groups. In this study, 120 children (40 cases and 80 controls) that were candidates for tonsillectomy were studied. The largest number of cases was males (60%). The mean age of patients with otitis media was 5.7 ± 2.6 years-old and in the control group was 7.2 ± 2.2 years-old. The mean levels of vitamin D in children with OME was 26.1 ± 14.6 ng/mL and in children in the control group was 29.5 ± 17.9 ng/mL (P = 0.27). Although there was not a significant relation shown between vitamin D levels between the two groups in our study, the vitamin D level in OME patients was less than in the control group. Therefore, it seems that measuring the level of vitamin D in these patients is necessary, and a deficiency of vitamin D must be treated. In order to achieve certain results with more detail we suggest more studies with larger sample sizes and covering a longer time period are needed on this topic.

Allergic rhinitis (AR) represents a global health problem, affecting 5-50% of the population worldwide and numerous classes of pharmacological agents are available for its treatment. Two more popular of these drugs are Loratadine and Cetirizine. There are few direct comparator studies between these two drugs with inconsistent results. A randomized, double-blind study for comparison the therapeutic effects of Loratadine and Cetirizine was conducted in an otolaryngologic clinic of a general hospital. Eighty patients with perennial allergic rhinitis were divided into two equal groups. One group received Loratadine 10 mg daily for two weeks and the other group Cetirizine 10 mg daily also for two weeks. Alterations of the allergic rhinitis symptoms including rhinorrhea, sneezing, nasal itching and nasal obstruction were compared between the two groups. Severity of all four studied symptoms was reduced by both drugs. Although Cetirizine had a little more efficacy, their difference was not statistically significant (P>0.05). These two medications were most effective in reducing the sneezing and least effective on the nasal obstruction. Loratadine and Cetirizine can reduce symptoms of the perennialallergic rhinitis but their difference is not statistically significant.

The cochlea and vestibule are related developmentally. Therefore individuals with severe to profound sensourineural hearing loss have additional risk for vestibular dysfunction. The aim of this study was to assess saccular function using vestibular evoked myogenic potentials (VEMP) in children with severe to profound sensorineural hearing loss (SNHL) who are candidates for cochlear implant. Thirty children (17 males and 13 females) with bilateral severe to profound sensorineural hearing loss in the age range of 3-15 years participated in this study. 17 children (9 males and 8 females) with normal hearing in the age range of 3-13 years participated as the control group. All children in each group were evaluated for saccular function by performing vestibular-evoked myogenic potentials in both ears. Comparison of mean threshold values between the two groups revealed statistically significant difference (p<0. 05). In addition، comparison of mean amplitude values between the two groups revealed statistically significant difference (p<0. 05). However، comparison of p1 3 and n23 latency values between the two groups revealed no significant difference (p>0. 05). Out of the 30 children with bilateral severe to profound sensorineural hearing loss eight children (26. 66%) had absent VEMP responses in both ears. Children with severe to profound sensorineural hearing loss who are candidates for cochlear implant ha d more potential for saccular abnormalities compared to normal-hearing children. Therefore، assessment of vestibular function is very important in this population.

Hyperbilirubinemia is one of the most common cause of congenital sensory neuronal hearing loss. These patients are screened by auditory brainstem response (ABR) test at bilirubin levels higher than 1% of gestational weight. Aim of this study is to determine whether hyperbilirubinemia less than 1% of gestational weight could induce hearing loss and abnormal auditory brainstem response (ABR). In this case control study the outcome of ABR test in children younger than 3 years old with a history of term delivery and hyperbilirubinemia (bilirubin level less than 1% of gestational weight) were compared with the control group without hyperbilirubinemia matched for age and gender. Mean ABR amplitude (wave I, V) were significantly prolonged in neonates with jaundice compared with controls (P<0.01). Based on receiver-operating characteristic curves, a bilirubin level of 0.6% of gestational weight was the best discriminator with a sensitivity and specificity of 100%. In logistic regression analysis the relative risk of having an abnormal ABR in bilirubin level>0.6% gestational weight was 2.25 with 95% confidence intervals (CI) (1.44-3.89 and p=0.02). Our study showed a relevant association between bilirubin levels less than 20 mg/dl and abnormal ABR.