keyvan kiakojuri

Parkinson's disease is a neurodegenerative and multisystem disorder affecting systems more than the motor system. The olfactory disorder is an early non-motor symptom of Parkinson's disease. The present study was conducted on 110 patients aged 50-95 years with a diagnosis of Parkinson's disease referred to the Neurology Clinic of Babol University of Medical Sciences between  2018-2019. The control group consisted of 50-95-year-old non-neurological patients who were matched for age and gender with patients with Parkinson's disease. Data were collected by examination, demographic and clinical information questionnaire (duration of disease, the severity of disease, symptom index), as well as Iranian smell diagnostic test. A p-value less than 0.05 was considered statistically significant. The mean age scores of Parkinson's disease and control groups were obtained at 69±9 and 66±9 years, respectively. The mean duration of the disease was 5 years. Patients with Parkinson's disease scored lower on the Iranian smell test, and olfactory function was significantly reduced in the case group (p <0.001). Based on the results, olfactory function in patients with Parkinson's disease was not significantly correlated with gender, marital status, education, place of residence, and occupation(p <0.05). Only olfactory dysfunction was increased with age (P=0.01). In addition, olfactory dysfunction showed no significant relationship with severity of disease, duration of disease, and clinical index sign. Rapid Iranian smell test with a cut-off of 3.5% had a sensitivity of 87.3% and a specificity of 66.4%. According to the obtained results,olfactory dysfunction is an important non-motor and a primary symptom in patients with Parkinson's disease and is not related to the duration and severity of motor symptoms and symptom index.

 Among different factors, middle ear infections are the most common causes of referral to an otolaryngologist. Currently, ciprofloxacin drops are an effective treatment for middle ear infections.

 The purpose of this study was to compare the therapeutic effects of ciprofloxacin drops and powder in chronic bacterial middle ear infections.

 The present randomized clinical trial was conducted at Ayatollah Rouhani Hospital in Babol, Iran. After suction clearance, the patients were randomly divided into two groups: the control group received ciprofloxacin drops and the case group received ciprofloxacin powder in the tympanic cavity. All patients were evaluated for improvement of symptoms after two weeks.

 Of the 125 patients, 60 (48%) had bacterial infection. There were 30 patients in the control and the case groups equally. Ear manipulation results showed that only 16.67% of the subjects had ear manipulation in the drop group, while that was 43.33% in the powder group. The frequency of itching, swelling and discharge was not significantly different between the two groups before the treatment, but this difference was significant after the treatment, especially in pain, swelling, and discharge. Overall, Pseudomonas aeruginosa, Enterobacteriaceae spp. and Staphylococcus epidermidis were the most common bacteria grown in culture.

 Owing to the better and more effective impact of ciprofloxacin drops than ciprofloxacin powder in improving the symptoms of patients, the use of ciprofloxacin powder is not recommended as a treatment for chronic bacterial infection of the middle ear.

Previous studies showed that one of the complications of rheumatoid arthritis disease was auditory disorder. The goal of the present study was to compare the auditory status in patients with rheumatoid arthritis and healthy individuals.

In the present case-control study, 30 normal persons and 60 persons with rheumatoid arthritis with mean age of 46.72 and standard deviation of 6.76 of both genders were appraised using pure tone audiometry, tympanometry and speech audiometry. The mean disease duration in patients with rheumatoid arthritis was 12.51±6.09 years.

The frequency of hearing loss in rheumatoid arthritis group was significantly more than the control group (p=0.001). All patients had sensorineural hearing loss. Only in 5% of rheumatoid arthritis group, abnormal tympanometry (as type) was reported. Speech discrimination score analysis showed significant difference between the patients with rheumatoid arthritis and controls. In terms of hearing threshold level, the mean hearing threshold level (in 2000, 4000 and 8000 Hz frequencies) of the patients with rheumatoid arthritis was significantly higher than control group in both ears (p<0.05). A positive significant correlation was found among mean hearing threshold level in 4000 and 8000 Hz frequencies and rheumatoid arthritis duration in both ears.

The frequency of hearing loss and the average hearing threshold in RA patients were higher than healthy individuals. The most common type hearing loss is sensorineural.

Otitis externa is an inflammatory in external auditory canal, with the presentation of otalgia, otorrhea, and pruritus. Bacteria and fungi are the most causative agents of the disease. Although several antifungal and antibacterial agents are usually used to treat it, combination therapy plays an important role in good treatment efficacy. According to the problems associated with the treatment of mixed otitis externa, the current study aimed at evaluating the efficacy of ceftazidime powder and topical miconazole (as the case group) versus topical miconazole only (as the control group) to treat mixed otitis externa. Seventy-two patients with mixed otitis externa were divided into two groups; the case group was treated with ceftazidime powder and topical miconazole, and the control group was treated only with topical miconazole. Both groups were evaluated after two weeks. The diagnosis of mixed otitis externa was based on signs, symptoms, and the presence of bacterial and fungal elements in direct examination and culture. Swelling, itching, and canal discharge were observed in 67.7%, 64.7%, and 90.3% of the patients, respectively in the case group, and 47.1%, 26.3% and 93.1% of the patients, respectively in the control group. Complete resolution of all clinical signs and symptoms occurred in 23 (67.6%) patients in the case group and 11 (28.9%) patients in the control group (P = 0.001). Staphylococcus epidermidis and Pseudomonas aeruginosa were the most common bacteria, and Aspergillus spp. and Candida spp. were the most common fungi identified in the cultures. According to the complete resolution of clinical signs, the application of ceftazidime powder and topical miconazole was better than topical miconazole to treat mixed otitis externa.

Otitis is a general terminology used for inflammation or infection of the ear; Staphylococcus aureus and Pseudomonas spp. are the most common causes of otitis externa. The resistance mechanism against the beta-lactams group is due to the production of β-lactamase enzymes by the bacteria; the enzymes in staphylococci are encoded by erm genes that confer inducible Clindamycin resistance.
This study aimed at investigating bacterial resistance by evaluating samples collected from Otitis Externa patients admitted to Ayatollah Roohani Hospital of Babol, Iran.
Ear samples were collected from 72 patients with Otitis Externa referred to Ayatollah Roohani hospital during May 2012 to 2013. At first, the isolated bacteria were identified using appropriate differential and selective media, and then were tested for antimicrobial susceptibility testing following the disk diffusion method. Special diagnostic tests were also performed for the identification of ESBL, iAmpC, pAmpC, metallo beta lactamase producers and inducible resistance to clindamycin and methicillin resistant strains. Data were analyzed by the SPSS 22 statistical software.
Among the 65 isolated bacteria, 24 (36.9%) cases were found to be gram negative and 41 (63.1%) were gram positive; pAmpC beta-lactamase producers were found to have the highest frequency in gram negative bacteria. From 36 (87.8%) isolated CoNS, 18 (50%) bacteria were found to be resistant to the methicillin group and 4 (11.1%) cases had inducible resistance to clindamycin; All isolated S. aureus were sensitive to methicillin and clindamycin.
Considering that some bacteria are concurrently able to produce different types of resistance enzymes, and also the fact that high prevalence rate of resistance belongs to CoNS, it is important and necessary to perform antimicrobial susceptibility testing as per clinical and laboratory standards institute (CLSI) methods in clinical laboratories.

Background and There are controversial findings regarding the efficacy of antifungal drugs in the treatment of a ruptured eardrum following fungal infections. Regarding this, the aim of the present study was to evaluate the therapeutic effect of the co-administration of antifungal and antibacterial agents in the treatment of otomycosis with tympanic membrane perforation.
This analytical, clinical trial was conducted on 87 patients with otomycosis showing no bacterial elements in the direct observation and culture. The study population was assigned into two groups of intervention (n=45) and control (n=42). The demographic and clinical data, as well as the data related to the direct observation and culture of the ear samples were recorded in a checklist. All statistical analysis was performed in SPSS (version 24).
The most prevalent symptoms in both groups were hearing loss and itching, and the most common finding was secretion. Aspergillus and Candida were the most frequent fungi isolated from the samples. After the implementation of combination therapy, the intervention group demonstrated a significant decrease in symptoms and signs, compared to the control group (P=0.005).
The findings of the present study indicated that the use combination therapy with ceftizoxime powder and clotrimazole ointment was effective the in treatment of the patients with tympanic membrane rupture showing no bacterial effects in direct examination and culture.

Acute otitis externa, an inflammatory condition of the external auditory canal, is a common clinical problem in general medicine.
This study aimed to determine the etiology of otitis externa in patients from the Mazandaran province, north of Iran, which has a humid climate, as humidity can affect the prevalence of pathogenic microorganisms.
Patients and This cross-sectional study involved 116 patients with otitis externa. Two sets of samples were collected from their ears; one set was used for slide preparations, and the other for microbial culturing. After culturing, the microorganisms were identified by conventional methods.
Patients between 35 and 44 years of age were most frequently affected (25.00%) by otitis externa (average age, 43.87 ± 18.08 years). Moreover, women (54.31%) were more frequently affected than men (45.69%). Upon direct investigation, Gram-positive bacilli were the most commonly identified microorganisms (22.41%). Furthermore, Bacillus spp. and coagulase-negative staphylococci (22.41% and 19.83%, respectively), were the organisms most frequently identified from cultures of otitis externa samples.
Direct examination and culture showed that a mixed infection of fungi and bacteria is the most common cause of otitis externa. The present study revealed that Bacilli spp. were the most abundant bacteria isolated from patients with otitis externa. Thus, it is recommended that both organisms should be considered as etiologic agents in protocols for treatment of otitis externa.