matin hashemishadmehri

Metastatic tumors in the nose and paranasal sinuses are rare. In the present paper, a 68 year old man with metastatic renal cell carcinoma to the left frontoethmoidal region 4 years after initial nephrectomy is presented ..Pathologic diagnosis of the case was Clear Cell Carcinoma. The patient complained of mild nasal obstruction and intermittent epistaxis, but the significant symptom was bulging in medial canthus from 20 days before. Clinical and endoscopic examinations of the left nasal cavity revealed a vascular mass in the axillary of the middle turbinate and anterior ethmoidal sinuses extending to the left orbital cavity .
The patient was treated with partial endoscopic sinus resection and chemoradiotherapy. He had a complete clinical response without any significant complications and recurrence of the tumor after 6 months follow up using interanasal endoscopic examination.

Severe pain following cesarean section is a complex physiologic reaction due to distention of gastrocolic regions، tissue impairment، and uterus contractions. This sort of pain can have unfavorable effects on different body systems. There are different drugs and various techniques to decrease such pain، e. g. ordinary oral and injectable analgesics; and rectal suppositories are available. Thepresent study aimed at comparing the effect of diclofenac، indomethacin، naproxen، and acetaminophen rectal suppositories on post-cesarean section pain. In this double-blind randomized clinical experimental study undertaken in Kerman Afzalipoor hospital، 125 pregnant women who had undergone cesarean section under general anesthesia، were randomly divided into 4 groups. In the recovery ward، after complaining of pain، the first and the second group members were administered 100mg of rectal diclofenac and indomethacin، respectively. The third and the fourth group members received 325mg and 500mg acetaminophen and naproxen، respectively; in the same manner. Then، the vital signs and Visual Analogue Scale (VAS) of each case were examined and evaluated at the time 0، 15 and 60 minutes after administration. The all cases were not significantly different regarding age، height، and weight. Moreover، the group receiving diclofenac experienced the most pain decrease within an hour based on VAS (P<0. 001). However، there was no significant difference among the other groups. Rectal diclofenac suppository significantly decreases pain one hour following cesarean section compared to indomethacin، naproxen، and acetaminophen.