maliheh akbarpour

Nasal septal abscess, which is the collection of purulent materials between the cartilaginous or bony septum and the mucoperichondrium or mucoperiosteum, often occurs after septal hematoma caused by trauma. Other common factors include surgery, foreign bodies, and sinusitis. In addition to the risk of nasal deformity, septal abscess can cause life-threatening complications such as osteomyelitis, orbital or intracerebral abscess.

This study aims to investigate the frequency of nasal septal abscess and its related factors in patients in north of Iran.

In this descriptive cross-sectional study on the patients referred to a hospital in north of Iran in 2022. Their demographic and disease-related information were recorded and the risk factors were finally identified.

In this study, 37 patients had septal abscess. The most common risk factor identified was a history of septoplasty or septorhinoplasty (35.1%), followed by diabetes mellitus (21.6%). Surprisingly, one of the factors in these patients was cauterization for epistaxis treatment (n=6). All patients were treated with broad-spectrum antibiotics and surgical drainage. In five patients, abscess resulted in saddle nose deformity. Positive culture results were reported in five samples.

Early identification of nasal septal abscess and its risk factors can help control the disease and prevent its serious complications.

Magnesium is essential for the morphogenesis of otoconia. The imbalance in the chemical composition of otoconia can make people susceptible to Benign Paroxysmal Positional Vertigo (BPPV). The primary outcome was to compare serum magnesium levels in BPPV patients with controls. The Ca/Mg ratios in participants are also recorded and analyzed in the present study.

In this case-control study, we measured the serum Mg, Ca, and vitamin D in BPPV patients and age-, sex-matched subjects without BPPV. The results were adjusted for Ca, vitamin D, hypertension, and body mass index.

A total of 123 BPPV patients participated in this study. The mean Mg value was higher in patients than controls (2.01 vs. 1.95 mg/dL, p=0.030). Condition logistic regression analyses showed a higher rate of BPPV among subjects with low Ca/Mg ratio (quartile 1), relative to subjects with medium ratio (quartiles 2 and 3) (adjusted OR: 3.92, p=0.003).

The present study demonstrated an imbalance of Ca and Mg in the BPPV patients as significantly higher Mg levels and lower serum Ca/Mg ratio. Although it appears decreased Ca/Mg ratio to be a risk factor for BPPV, this result should be confirmed in confirmatory studies.

 Among facial plastic surgical procedures, septorhinoplasty is deemed the most complex. A critical stage in this process is the effective handling of variations in the septum and turbinate. This research aimed to assess the differences and pathological irregularities in the septum and lateral nasal wall of patients scheduled for septorhinoplasty at a university-based hospital in northern Iran.

 This cross-sectional study focused on all septorhinoplasty candidates aged between 18-60 years. Observations during surgery, such as the location and category of septal abnormalities, and the location and type of lateral nasal wall abnormalities (including lower and middle turbinate hypertrophy, concha bullosa, and paradoxical turbinate) were meticulously documented and analyzed.

 Of the 672 participants, 469 patients (69.8%) presented with septum abnormalities, while 143 patients (21.3%) demonstrated disorders of the lateral nasal wall. The most frequent findings were spurred vomer (24.6%) and lower turbinate hypertrophy (46.9%).

 Given the broad range and high incidence of disorders in the septum and lateral nasal wall, it is reasonable to routinely incorporate radiological investigations into the preoperative assessment of surgical candidates. This approach can potentially identify pathological findings, minimize postoperative complications, and optimize the surgical outcomes.

 Patients who undergo major orthopedic surgery are at risk of acute kidney injury (AKI) due to blood loss, electrolyte disorders, infection, and other co-morbidities. In this study, we aim to investigate the frequency of AKI and its risk factors in patients undergoing major orthopedic surgery in Rasht, Iran.

 This is an analytical cross-sectional study on 180 patients undergoing major orthopedic surgery. Those with a history of chronic kidney disease and dialysis were excluded. 

 The data including patients’ age, gender, drug history, history of underlying diseases, duration of surgery, mean arterial pressure during and after surgery, and use of inotrope during and after surgery, and creatinine level before and after the surgery. 

 The mean age of patients was 47.3±22.8 years. The incidence of AKI was 11.11%. The use of some drugs, duration of surgery, MAP, and inotrope use had no significant relationship. The occurrence of AKI had a significant relationship with the history of heart disease, diabetes, and kidney disease. Multiple linear regression analysis results showed that with the increase of one unit in preoperative creatinine level, the postoperative creatinine level increased by 0.3.

 The incidence of AKI after major orthopedic surgery in Rasht city is relatively high. Careful monitoring of kidney function before, during, and after major orthopedic surgery is important; it can prevent the occurrence of postoperative AKI.

 Postoperative sore throat (POST) syndrome commonly occurs after general anesthesia and surgery, leading to patient discomfort.

 This essay aims to assess the effect of using zinc-impregnated packs on sore throat and post-op nausea and vomiting after general anesthesia among patients undergoing septorhinoplasty.

 The sampling method was based on the patients’ gradual referral, and encompassing was performed using the randomized block. The participants were divided into four groups by random allocation technique considering the type of pharyngeal packs: (1) Normal saline-impregnated vibril, (2) Normal saline-impregnated gauze, (3) Zinc solution-impregnated vibril, (4) Zinc solution-impregnated gauze. The sample size required to compare the incidence of sore throat after septorhinoplasty was determined to be 220 patients.

 Out of 220 patients undergoing septorhinoplasty, 55 were assigned to each group. According to A.S.A., most of the patients belonged to class I. In total, 5.5% and 15.1% had a history of gastroesophageal reflux disease (GERD) and smoking, respectively. There was no statistically significant difference among the four groups in terms of the sore throat immediately (P = 0.227), two h (P = 0.527), four h (P = 0.505), six h (P = 0.564) and 24 h (P = 0.481) after surgery. Results of pairwise comparison revealed no statistical difference between the groups receiving zinc and other groups. There was no statistically significant difference between the four groups in terms of the severity of sore throat. A statistically significant difference was observed between the gauze + zinc and gauze + normal saline groups regarding the incidence of nausea two hours after surgery (P = 0.0045).

 This study showed that applying topical zinc to the pack had no significant effect on reducing sore throat. However, there was a significant difference between the groups receiving zinc solution-impregnated gauze and normal saline-impregnated gauze in terms of the severity of nausea two h after surgery.

COVID-19 is an acute respiratory disease, caused by a coronavirus named SARS-CoV-2. Previous reports suggest an association between COVID-19 infection and Hearing Loss (HL). We have investigated the Universal Newborn Hearing Screening (UNHS) results in the time period of COVID-19 epidemic in Guilan Province, north of Iran.

We analyzed UNHS results from10 major obstetrics hospitals from 20th Mar 2020 to 19th Mar 2021, and compared the total UNHS positive/“refer” and total neonatal HL reports with the same time periods of recent three years. The prevalence of risk factors for HL were analyzed during the same period.

The total number of childbirth was decreased significantly from 27735 birth cases in Mar 2017-2018 to 18216 births in Mar 2020-2021 (p<0.001), but the total “refer” rate was significantly increased from 63.0 per 1,000 births in Mar 2019-2020 to 79.8 in Mar 2020-2021 (OR=1.29, 95% CI: 1.19-1.39, p<0.001), and also increased from 74.7 per 1,000 births in Mar 2017-2020 to 79.8 in Mar 2020-2021 (OR=1.07, 95% CI: 1.01-1.14, p=0.020). The HL rate increased from 10.3 per 10,000 births in Mar 2019-2020 and from 11.4 per 10,000 births in Mar 2017-2020 to 18.7 in Mar 2020-2021 (OR=1.81 and 1.63, 95% CI: 1.06-3.09 and 1.10-2.44, p=0.028 and 0.015, respectively). The prevalence of preterm birth (p=0.039) and neonatal intensive care unit stay (p=0.016) was increased significantly during Mar 2020-2021.

The chance of “refer” results and neonatal HL, found in the UNHS program, increased during the COVID-19 epidemic in comparison to the past years.

Traumatic pseudoaneurysm of the supratrochlear artery is a rare lesion. It manifests, as a painless mass, in the frontal region following trauma. The unusual incidence and confusing presentation require the clinicians to thoroughly understand its presentation and diagnosis. Diagnosis is typically made on history and physical examination, but it can be confirmed by duplex ultrasound. Definitive treatment is surgical resection of the aneurysm after proximal and distal ligation of the vessel. However, in some cases, follow-up is recommended because there is a possibility of spontaneous relapse.

We present a case of traumatic pseudoaneurysm of the supratrochlear artery, which developed a few weeks after blunt trauma to the forehead. The radiologist reported a pseudoaneurysm originating with a narrow stalk of the supratrochlear artery. In the patient’s followup after three months, the patient’s mass became very small, and in the follow-up after five months, the mass completely disappeared.

Pulsatile and or soft-tissue masses that are continuous with an artery with a history of trauma should be considered pseudoaneurysm. Color Doppler sonography is a convenient and noninvasive modality in diagnosis. If the pseudoaneurysm of the supratrochlear artery is small and contains thrombosis, waiting and seeing might be an effective option.