reza kaboodkhani

Many studies have been done on the use of aloe vera in wound healing, but fewer studies were done on the influence of this material on the reduction of the alar scar. Therefore, we evaluated the effect of a newly made aloe vera cream on alar wound healing after rhinoplasty.

This was a randomized, double-arm, parallel-group, double-blind controlled trial and was done from June 2021 to February 2022.  External wedge resection was done for all patients. The patients were randomly assigned to receive aloe vera cream (n=31) (intervention group) or Face Doux cream (comparison group) (n = 29). A pharmacist prepared the aloe vera cream. The primary outcome measure was the wound scar status which was assessed by two Questionnaires, including the mean Patient Scar Assessment Questionnaire (PSAQ) and Vancouver Scar Scale (VSS). Randomization and Blinding were done.

The mean PSAQ was significantly lower in group A after two weeks (26.9 versus 31.5, P<0.001), after two months (15.7 versus 19.6, P=0.04), and six months follow-up (8.8 versus 11.8, P=0.005). The mean VSS was significantly lower in group A after two weeks (5.6 versus 7.1, P=0.001), after two months (3.5 versus 4.9, P=0.002), and six months (1.2 versus 2.7, P<0.001). Repeated measurement analysis showed that both interventions significantly affected PSAQ and VSS.

Although both interventions had a significant effect on PSAQ and VSS, compared to Face Duox, the topical use of Aloe Vera cream significantly reduced scar formation after alar resection, both statistically and clinically.

Chronic rhinosinusitis (CRS) is a high prevalent disease throughout the world. The aim of this study was to investigate the epidemiological and clinical characteristics of the CRS patients.

A total of 241 CRS patients aged 15-70 years were recruited. The prevalence of allergic diseases and its association with CRS, disease severity, and quality of life (QoL) were assessed using GA2LEN and SNOT-22 questionnaires, respectively. Patients' clinical diagnoses and allergic comorbidities were evaluated using paranasal sinus computed tomography (CT), nasal endoscopy, and paraclinical tests (smell identification test, fractional exhaled nitric oxide (FeNO), skin prick test (SPT), pulmonary function test (PFT)).

The mean (±SD) age of all participants was 40.1±11.1 years, with a gender distribution of 56% male and 44% female. Nasal polyps (NP) were diagnosed in 42.4% of patients. The total mean SNOT-22 scores and the mean scores of the nasal symptoms category were significantly higher in CRS patients with NP (CRSwNP) compared to CRS without NP (CRSsNP) (OR = 2.3, 95%CI = 9.6–0.55, P = 0.028). Furthermore, there was a significant association between CRSwNP and persistent allergic rhinitis comorbidity (P = 0.006). Finally, a significant association was found between CRSwNP and severe SPT reactivity to Dermatophagoides farina and date palm pollen (P = 0.04 and P < 0.001, respectively).

This study suggests that higher SNOT-22 scores may impact QoL in CRSwNP patients. Additionally, a significant association was found between CRS and respiratory allergic diseases.

Rhinoplasty is a complex but popular surgery in Iran. The main complications of the surgery are post-operative bleeding and nasal septal hematoma due to poor intra-operative controlled hypertension. This study aimed to compare the efficacy of isoflurane-remifentanil (I-R) versus propofol-remifentanil (P-R) to induce controlled hypotension and to assess surgeon satisfaction with each of these combinations during rhinoplasty.  In 2020-2021, a single-blind clinical study was conducted on 98 patients aged 18-50 years undergoing rhinoplasty at Mother and Child Hospital (Shiraz, Iran). Patients were randomly divided into P-R (n=48) and I-R (n=50) groups. Changes in systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), and heart rate (HR) were assessed during surgery and in the recovery room. A questionnaire was used to evaluate the level of surgeon satisfaction. Data were analyzed using independent samples t test, Chi-square test, and repeated measures ANOVA with SPSS software. P<0.05 was considered statistically significant. Five minutes after anesthesia induction, the P-R combination had a greater effect on reducing SBP (P=0.010), DBP (P=0.007), MAP (P=0.003), and HR (P=0.026) than I-R. However, from the 40th minute to the end of surgery and after 30 minutes of recovery, the I-R combination had a slightly better effect on blood pressure reduction than P-R. There was no difference in surgeon satisfaction with either of the two drug combinations. Both P-R and I-R combinations are recommended to induce hypotension during rhinoplasty. However, I-R is more effective than P-R in inducing the desired controlled hypotension.

Aspirin exacerbated respiratory disease (AERD) is known by the triad of chronic rhinosinusitis with nasal polyposis (CRSwNP), aspirin hypersensitivity, and asthma, but its etiology and physiopathogenesis are still unclear. This cross-sectional study was designed to investigate allergy and inflammatory cells (neutrophils vs. eosinophils) dominancy in nasal polyp tissue of patients with AERD compared to non-AERD patients. CRSwNP patients scheduled for endoscopic sinus surgery were recruited in this study. Nasal polyp tissue was analyzed for infiltrating cells, and Eosinophil dominant and neutrophil dominant polyps were determined. AERD was confirmed by oral aspirin challenge (OAC). Demographics data; history of asthma, exacerbation by using NSAIDs, routine use of aspirin, type of surgery (primary or revision), and results of skin prick test and spirometry were recorded. Pathology results and contributing factors compared between AERD and non-AERD patients. Sixty-five patients (39 women, 26 men) were enrolled in the study (mean age 38.83 ± 12.43 years). Thirty (46%) patients had positive OAC tests. Totally 41 patients (63.1%) had eosinophilic polyps. 80% of patients with eosinophilic polyp had positive OAC and were AERD (P < 0.05). There was no significant difference in demographics, revision surgery, and concomitant asthma between AERD and non-AERD groups (P > 0.05). The positive skin prick test was higher in AERD and also in eosinophilic polyp patients, but it was not statistically significant (P = 0.086 and P = 0.177). Eosinophilic polyps are more common in AERD. A positive skin prick test is associated with AERD and eosinophilic polyp.

Allergic rhinitis (AR) is a prevalent disease affecting the quality of life of patients throughout the world. This study aimed to assess the prevalence of AR and its association with chronic rhinosinusitis (CRS) in the adult population living in Bushehr, southwestern part of Iran. In this population-based study, a total of 5420  individuals aged 15-65 years were selected through a multi-stage, cluster, random sampling method from which 5201 of them completed the Global Allergy and Asthma Network of Excellence (GA2LEN) questionnaire (Response rate=96.1%). The prevalence of AR, based on Allergic Rhinitis and Its Impact on Asthma (ARIA) classification (mild or moderate; intermittent or persistent) was calculated and the association of AR and CRS was evaluated using a multiple logistic regression model. The overall prevalence of AR was 28.8%, and for the intermittent and persistent AR were 25.9% (out of which 81.34% were moderate to severe) and 74.1% respectively. Moreover, the prevalence of AR was significantly higher in health workers and smokers (p=0.002 and p<0.001, respectively). Furthermore, an association was found between AR and CRS (p<0.001, aOR: 4.68, 95%CI: 4.07-5.39), and also, between the persistent AR and CRS as compared with the intermittent (p<0.001, aOR: 4.21, 95%CI: 3.40-5.22). The present study showed that the prevalence of AR in Bushehr (Southwestern part of Iran) was significantly high. In addition, the results indicated a strong association between AR and CRS, especially in individuals with moderate to severe persistent AR.

Medical malpractice and violations and following that litigation by patients and finally recycling by them, is faced doctors and medical community with the growing crisis. Medical malpractice, ie, abuse of the specific requirements of the medical profession has the responsibility of doctor In fact, Including diagnosis and treatment and disease management mistakes

This study is a retrospective cross-sectional study to determine Seven years old complaints about facial cosmetic surgery that referred to forensic medicine of Fars province that in 1385 to 92 years was conducted.

In terms of gender between men (34/5%) and women (65/5%) relatively large differences can be seen in the complaint. In our study in according to marital status a huge difference between married (36/4%) and single (54/6%) was seen in the complaint. Most physician were specialist with 57.4% (n = 31), and then Subspecialty with 27.8% (n = 15) and general practitioners were (13%) of cases. According to the results, 60% (n = 33) of physician were acquitted and 40% were sentences (n=22). The results of most frequent type of expertise (n=28) is related to ENT specialists (50.9%), followed by plastic surgery with 29.1% (n = 16) and GP (12.7%).The area of operation, the rhinoplasty is the most frequent complaint among the plaintiffs in 32 cases (58.2%). The type of malpractice, most malpractice was using inappropriate techniques with 27/3% of cases. In this regard, lack of skill, complications of treatment and compound, any 22/7% allocated to own.

Cutaneous mucomycosis is an invasive fungal infection that usually develops in the immunodeficient patients. Although it also occurs in cases without underlying disease. So far in Iran and the world, primary cutaneous mucormycosis of the neck without predisposing factor has not  been reported.

In this case,we present a 51 years old patient with progressive neck swelling and skin necrosis without any underlying disease. Firstly, treated as Ludwig Angina and necrotizing fasciitis. Finally diagnosed as neck mucormycosis according to pathologic result. systemic antifungal treatment and multiple surgical debridements with close intervals performed for him.

Primary cutaneous mucormycosis should be considered in any case of cutaneous necrosis ,even without underlying disease. A multidisciplinary approach is essential to improve survival rate of neck mucormycosis patients.

Rapid diagnosis and initiation of systemic antifungal therapy along with invasive surgical debridement  can  improve survival rate and subsequent soft tissue reconstruction of  the neck mucormycosis in patients without underlaying disease.

90% of the tumors in the head and neck are squamous-cell carcinomas (HNSCC), which have overall 5- year survival rate between 50% -60%. CD44 has been shown to be associated with the prognosis.
Biopsy specimens of 51 patients with oral tongue SCC were evaluated by Immunohistochemistry (IHC) for the CD44 antibody.
There was no significant correlation between CD44 and survival (P=0.77), age (P=0.4), CD44 and lymph node metastasis (P=0.87), sex (P=0.947), smoking (P=0.287) and tumor size (P=0.813). However, there was significant correlation between smoking and survival.
There are widespread discrepancies among the findings in the literature regarding the prognosis of CD44 expression in OCSCC. Our study shows that the expression of CD44 is not a marker of aggressive behavior in oral tongue SCC. Consequently, CD44 cannot be considered as handy tool to establish the tumor behavior, prognosis and 5- year survival rate of these tumors.

Tonsillectomy is associated with early and late postoperative complications in the children. Previous studies have shown some effects of dexamethasone; however, there has been a lack of studies that evaluate its effects on other complications, including odynophagia and otalgia. We aimed to investigate the effects of dexamethasone on odynophagia and otalgia after surgery.Patients and In this randomized clinical trial, 100 patients who underwent adenotonsillectomy were divided into two groups: one group received 0.1 mg/kg of dexamethasone (case) and the other received Ringer serum as a placebo (control). Intravenous (IV) dexamethasone was prescribed to be administered by a nurse on the ward. The incidence of bleeding, nausea and vomiting, odynophagia, voice change, acetaminophen intake, halitosis and otalgia, and activity were evaluated at 24 h and during the first 7 days after surgery. The mean ages of patients were 7.1 ± 2.8 and 6.5 ± 2.4 years in the control and case groups, respectively. The overall proportions of females and males were 41% and 59%, respectively. No significant difference in demographic data was seen between the two groups (P > 0.05). There was a significant difference in terms of odynophagia and nausea and vomiting between the case and control groups after 24 h (P = 0.001). There was no significant difference between the case and control groups in terms of bleeding, voice change, halitosis, or nausea and vomiting after 7 days (P > 0.05). Meanwhile, there were a significant difference in the incidence of acetaminophen intake (60% vs. 30%, P = 0.002), odynophagia (24% vs. 6%, P = 0.011), otalgia (20% vs. 4%, P = 0.014), and activity (80% vs. 98%, P = 0.004) of patients after 7 days between the groups. In children undergoing adenotonsillectomy, dexamethasone has a significant antiemetic effect and decreases odynophagia, otalgia, and the need for analgesia.