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Introduction: Fungal otitis extern or otomycosis, is common worldwide, and resistance of fungal organisms to antifungal drugs has been reported in otomycosis and other fungal infections. This study aimed to evaluate the clinical efficacy of sertaconazole versus placebo, as well as miconazole and clotrimazole topical creams in otomycosis patients. Materials and Methods: In this double-blinded clinical trial, 138 otomycosis patients (230 ears) were evaluated in four groups. After the first session of the ear canal debridement and irrigation with acetic acid 2% solution, the patients were treated with either A) sertaconazole 2% cream, B) miconazole 2% cream, C) clotrimazole 2% cream, or D) placebo. The results of clinical evaluations and response to treatment (complete, partial, and no response) were recorded at the time of the first visit and by the end of the first, second, and fourth weeks of treatment. A p-value less than 0.05 was considered statistically significant. Results: Response results to treatments, ear itching, aural fullness, otalgia, and otorrhea revealed significant differences in either group A or groups B and C, compared to the placebo group (P<0.05). Considering both complete and partial responses together, the sertaconazole group showed a 96.43% response rate. For complete response, miconazole revealed better results, compared to the other two creams; however, the differences for the therapeutic outcomes were not statistically significant. No adverse reactions were observed in the study groups. Conclusions: Sertaconazole had comparable results with miconazole and clotrimazole in the treatment of otomycosis, and especially if complete and partial responses were considered together, it was more efficacious than miconazole and clotrimazole creams. [ABSTRACT FROM AUTHOR]

Background For many years, Canal Wall Down (CWD) tympanomastoidectomy has been the gold standard for treatment of cholesteatoma; however, this method has long-term complications for the patients. The Intact Canal Wall (ICW) tympanomastoidectomy has relatively lower complications, but access to the middle-ear recesses is difficult in this method. Therefore, endoscopy is used to visualize the underexposed recesses. Objective This study aims to compare the incidence of residual cholesteatoma using the two methods of CWD and endoscopic-assisted ICW. Materials and Methods In this prospective randomized clinical trial, participants were 40 patients with cholesteatoma in the middle ear and mastoid who were candidates for tympanomastoidectomy. They were randomly divided into two groups. In the first group, ICW was performed with endoscopic assisted visualization, while in the second group, conventional CWD technique was performed without ossicular reconstruction. All the patients were microscopically examined at 3, 6, 9 and 12 months after surgery. Revision middle ear surgery and possible ossicular reconstruction under local anesthesia were performed one year after the surgery. The presence of cholesteatoma pearl in the middle-ear, evaluated by using a 2.7mm 30° endoscope, was recorded as the sign of residual cholesteatoma. Fisher's exact test and Mann-Whitney U test were used for statistical analysis. Significance level for the tests was set at 5%. Results The incidence of residual cholesteatoma was not statistically significant between the two groups (P>0.05). In each group, 20% (n=4) had residual cholesteatoma. The difference in time interval from the first to second surgery was not statistically significant between the study groups (P>0.05). Conclusion Endoscopic-assisted ICW tympanomastoidectomy is comparable with CWD tympanomastoidectomy in eradication of cholesteatoma, having possibly fewer complications. It is recommended that more studies be conducted with a larger sample size and longer follow-up period. [ABSTRACT FROM AUTHOR]

Background: In this study, we aimed at evaluating the frequency of chemoradiotherapy-induced mucositis (CIM, RIM) and its related risk factors in patients with the head-and-neck cancers (HNCs). Materials and Methods: In this cross-sectional prospective descriptive study, we evaluated a total of 54 HNCs patients referred to the Oncology Chemoradiotherapy Department of Razi and Amiralmomenin University Hospitals of Rasht, for site and grade (WHO classification) of CIM/RIM, based on their demographic features and possible risk factors. SPSS software version 18 and statistical tests (i.e., Fisher's exact test) were used, and the level of significance was considered as P < 0.05. Results: Finally, patients enrolled in the study were 34 men and 20 women (40–72-year-old), of which 43 cases (79.6%) showed signs and symptoms of CIM/RIM (mostly aged 60–69-year-old). Grade 2 mucositis was the most frequent type (18 cases: 33.3%) and mouth floor was the most common site of CIM/RIM (15 patients: 34.9%). Age (P = 0.023), gender (P = 0.012), and the severity of pain (P = 0.018) were significantly related to mucositis in patients with HNCs who underwent chemotherapy or radiotherapy. Conclusion: Mucositis, especially in the oral cavity, is a common complication of chemoradiotherapy in HNCs patients. Age, gender, and the severity of pain are significantly associated with the frequency of CIM/RIM. [ABSTRACT FROM AUTHOR]

Evaluation of the research status of the academic institution provides it with the possibility of accurate research policymaking. Scientometric indicators are important tools for evaluating scientific activities of individuals, groups, and institutions. The current research aims to analysis the research performance of medical universities in Northern Iran based on quantitative and qualitative scientometric indicators. In this cross-sectional descriptive study, the Scopus-indexed scientific documents provided by medical universities in the Northern Iran have been studied in terms of number of publications, number of citations, average number of Citations per Publication (C/P), Field-Weighted Citation Impact (FWCI), scientific collaborations, the number of in top 10% citation percentile, and the number of publications in top 10% journal percentile according to CiteScore, Source Normalized Impact per Paper (SNIP), and SCImagoJournal Rank (SJR) indicators during a five years period. According to the findings, Mazandaran University of Medical Sciences has gained the highest position in terms of the number of publications and citations, number of publications with international and national collaborations, and academic-industrial collaborations., while Golestan University of Medical Sciences has gained a higher position in terms of scientific outputs in top 10% citation percentile and journal percentile, CiteScore, SNIP, SJR and C/P. In terms of the FWCI indicator, Golestan University of Medical Sciences has achieved the highest value. Considering academic status and research capabilities of medical universities in the Northern Iran, increasing academic-industrial collaboration, expanding academic collaboration with superior universities and institutions around the world can be effective in increasing the quality of research and upgrading academic ranks of universities at national, regional and international levels. [ABSTRACT FROM AUTHOR]

Sarcoidosis is a systemic idiopathic disease, characterized by non-caseating granulomas, primarily affecting the lungs and the lymphatics. Skin involvement is common and lesions may appear in scar tissues. In the present report, four cases of scar sarcoidosis following rhinoplasty are presented which were diagnosed based on serology tests, radiography imaging and histopathology findings. Three women and one man between 32 to 54-year-old are discussed in this report. Skin lesions on their nose were found after an average of 3.8 years of their septorhinoplasty surgeries. Two of the patients had systemic signs such as fever, cough and arthritis. Patients with diagnosed sarcoidosis were treated appropriately. Rhinoplasty is a common procedure today, and the fact that rhinoplasty may lead up to scar sarcoidosis in susceptible people can be an item for surgeons for consideration. [ABSTRACT FROM AUTHOR]

Introduction: Chronic rhinosinusitis (CRS) with and without nasal polyposis is a chronic inflammatory disease of the sinuses and nasal mucosa. Recent evidence has indicated a relationship between serum 25-hydroxyl vitamin D (OH-VitD) deficiency and CRS. Regarding this, the present study aimed to compare the serum level of 25-OH-VitD in CRS patients with and without nasal polyposis and control groups. Materials and Methods: This study was conducted on 117 adult subjects in three groups of CRS with nasal polyposis (CRSwNP; n=32), CRS without nasal polyposis (CRSsNP; n=35), and healthy controls (n=50). The mean level of serum 25-OH-VitD in the three groups was measured by means of enzyme- linked immunosorbent assay. The data were analyzed using SPSS software (version 18). Results: Mean serum levels of 25-OH-VitD in CRSwNP, CRSsNP, and control groups were 12.52, 15.54, and 22.04 ng/ml, respectively. There was a significant difference between the case and control groups in terms of 25-OH-VitD level (P=0.0001). However, no significant difference was observed between the CRSwNP and CRSsNP groups in this regard (P=0.464). The women had a VitD deficiency odds ratio (OR) of 2.47, compared with men (OR=2.47, 95% CI=1.04-5.86). The OR of VitD deficiency with aging was obtained as 0.957 (95% CI=0.925-0.989). In this regard, older patients had a lower probability of VitD deficiency, compared to younger patients. Conclusion: As the findings indicated, serum 25-OH-VitD was significantly lower in CRS patients, compared with that in the non-CRS subjects. [ABSTRACT FROM AUTHOR]

Chronic dacryocystitis is an inflammation of the lacrimal sac that usually occurs because of obstruction of the nasolacrimal duct. The aim of this study was bacteriological evaluation of samples from patients with acquired chronic dacryocystitis that were operated in Amiralmomenin university Hospital, Rasht-north of Iran. This cross sectional study included 50 patients with chronic dacryocystitis who were operated by endoscopic or external DCR (Dacryocystorhinostomy). Specimens were obtained for bacteriological investigation by sterile wiping swab across muco-purulent exudate for pus and a block of medial wall of lacrimal sac for tissue studying. All samples were cultured and microbiological methods used for identification of grown colonies. Antibiogram was performed for isolated bacteria according to CLSI guideline. Among 50 patients (34 female, 16 male), bacterial cultures of exudates were positive in 25 (50%) of cases and tissue samples were positive in 13 (26%) patients. Staphylococcus epidermidis was the most prevalent organism both in exudates and tissue samples (18% and 8%, respectively) that had the most susceptibility to ceftriaxone. Among Gram-negative organisms, a higher incidence of Pseudomonas aeruginosa was achieved in exudates, but not in tissue samples. P aeruginosa was resistant to penicillin, azithromycin, ceftazidime and gentamycin but most strains were susceptible to ciprofloxacin. In our study, the most prevalent organisms were S. epidermidis and P aeruginosa. Our findings suggest that tissue culture is not superior to exudate swabbing in aspect of bacterial isolation in these patients. [ABSTRACT FROM AUTHOR]

Introduction: Foreign-body aspiration is still considered one of the most important diagnostic and therapeutic issues for physicians. Mortality rates and the prevalence of diseases caused by foreign bodies in the airway are higher in children because of the relatively narrow airway and immature protective mechanisms. The aim of this study was to study the pattern of foreign-body aspiration in the tracheobronchial tree as well as the success rate of rigid bronchoscopy in children admitted to the Amir-al-Momenin Hospital, Rasht during 2007-2014. Materials and Methods: In this cross-sectional descriptive study, the required data were collected from the medical reports of all children under the age of 14 years with suspected foreign-body aspiration who were admitted and underwent explorative rigid bronchoscopy from 2007-2014. The data recorded in the checklists were analyzed using SPSS V16. Results: Out of 103 children with suspected foreign-body aspiration, a foreign body was seen in 74 children (71.8%) during bronchoscopy. Among 74 patients with a confirmed aspiration, 73% (54) were males and 27% (20) were females (P=0.68). The average age of the subjects was 34.82±33.4 months; 66.2% were aged 1-3 years. The most common complaints (symptoms) of patients were non-productive cough (48.6%), wheezing (44.3%) and respiratory distress (18.6%). The most common physical examination findings were unilateral decreased pulmonary sound (62.3%), generalized wheezing (26.1%), and crackles (17.4%). Sixty-three patients had a suspected history of foreign-body aspiration. The most frequently aspirated foreign bodies were nuts (peanuts). In total, 52.7% of foreign bodies were lodged in the right bronchial tree. In 95.9% of cases, the foreign body was completely extracted by bronchoscope. The majority of cases were admitted more than 24 hours after the occurrence of aspiration, and pneumonia was the most common complication. Conclusion: Patient history, especially initial suspicion of aspiration, coughing, wheezing and respiratory distress, can be helpful in the diagnosis of foreign-body aspiration. [ABSTRACT FROM AUTHOR]

Introduction: Chronic suppurative otitis media (CSOM) is considered one of the most common causes of acquired hearing impairment in developing countries. CSOM is a multifactorial persistent inflammatory disease of the middle ear. A distinct pathophysiologic mechanism linking allergic rhinitis (AR) and CSOM remains to evolve. The purpose of this study was to investigate the association between AR and CSOM in adults. This was a case-control study. Materials and Methods: The subjects were 62 adults (23 male, 39 female) with established CSOM and 61 healthy controls. CSOM was diagnosed when there was a history of chronic (persisting for at least 3 months) otorrhea, accumulation of mucopurulent exudates in the external auditory canal or middle ear and/or perforated tympanic membrane on otoscopy. All participants were evaluated for the presence of AR by clinical evaluation of allergic symptoms, and underwent a skin-prick test for 23 common regional allergens. Statistical analysis was performed using SPSS version 16. Results: The prevalence of clinical rhinitis (allergic and non-allergic) was significantly higher among the cases compared with controls (62.5% vs. 37.5%, P=0.02). The prevalence of AR (proven by positive skin-prick test) was also significantly higher among affected adults than controls (24.6% and 13.8%, respectively). Adjusting for age, a logistic regression model showed that there was a significant difference between the two groups. Patients with AR and non-AR were at 3.27- (95% CI=1.15-9.29; P=0.036) and 2.57-(95% CI=1.01-6.57; P=0.048) fold increased risk of developing CSOM, respectively, compared with healthy individuals. Conclusion: The study showed a higher prevalence of AR in CSOM patients than in controls. It may be valuable to evaluate and control this factor in these patients. [ABSTRACT FROM AUTHOR]

While most tinnitus cases have some degree of hearing impairment, a small percent of the patients admitted to Ear, Nose and Throat Clinics or Hearing Evaluation Centers are those who complain of tinnitus despite having normal hearing thresholds. Present study was performed in order to better understanding of the probable causes of tinnitus and to investigate possible changes in the cochlear and auditory brainstem function in normal hearing patients with chronic tinnitus. Altogether, 63 ears (31 ears with tinnitus and 32 ears without tinnitus) were examined. The prevalence of transient evoked otoacoustic emissions and characteristics of the auditory brainstem response components including wave latencies and wave amplitudes was determined in the two groups and analyzed with appropriate statistical methods. There was no difference between the prevalence of transient evoked emissions in the two groups. The mean difference between absolute latencies of waves I, III and V was less than 0.1 ms between the two groups that were not statistically significant. Also, the interpeak latency values of I-III, III-V and I-V in both groups had no significant difference. Only the V/I amplitude ratio in the tinnitus group was significantly larger than the other group (p =0.04). The changes observed in amplitude of waves, especially in the later ones, can be considered as an Audiologic finding in normal hearing tinnitus subjects and its possible role in generation of tinnitus in these patients must be investigated. [ABSTRACT FROM AUTHOR]

Background and Aim: While most of the people with tinnitus have some degrees of hearing impairment, a small percent of patients admitted to ear, nose and throat clinics or hearing evaluation centers are those who complain of tinnitus despite having normal hearing thresholds. This study was performed to better understanding of the reasons of probable causes of tinnitus and to investigate possible changes in the auditory brainstem function in normal-hearing patients with chronic tinnitus. Methods: In this comparative cross-sectional, descriptive and analytic study, 52 ears (26 with and 26 without tinnitus) were examined. Components of the auditory brainstem response (ABR) including wave latencies and wave amplitudes were determined in the two groups and analyzed using appropriate statistical methods. Results: The mean differences between the absolute latencies of waves I, III and V was less than 0.1 ms between the two groups that was not statistically significant. Also, the interpeak latency values of waves I-III, III-V and I-V in both groups had no significant difference. Only, the V/I amplitude ratio in the tinnitus group was significantly higher (p=0.04). Conclusion: The changes observed in amplitude of waves, especially in the latter ones, can be considered as an indication of plastic changes in neuronal activity and its possible role in generation of tinnitus in normal-hearing patients. [ABSTRACT FROM AUTHOR]

Introduction: Otosclerosis is a disease of bony labyrinth. Structural changes in the labyrinth often cause ossicular fixation, and thus conductive hearing loss. The purpose of this study was to evaluate middle ear exploration findings and frequency of ossicular and footplate area anomalies in patients with suspected otosclerosis referred to Amiralmomenin and Golsar Hospitals in Rasht, Iran. Materials and Methods: In 47 patients undergone middle ear exploration in Amiralmomenin and Golsar hospitals from April 2001 to March 2011, the intraoperative findings, and other data were extracted from the medical records of the patients. The data was analyzed using SPSS 17 software. Results: Frequency of fixation of stapes, malleus, and incus by age and sex in patients undergoing middle ear exploration showed that stapes had been fixed in 39 patients, malleus in 6 patients, and incus in 21 patients. Analysis of data showed that there was no significant association between sex and age with fixation of any of ossicles (P>0/05). Middle ear anomalies were seen in 16 cases (34.0%). Overhanging of facial nerve in 4 cases, thick stapedial crura in 5 cases, and perilymph gusher in 2 cases were the most frequent anomalies. Conclusion: This study show that the results of middle ear explorations in our patients in the north of Iran is somehow different from the typical otosclerotic cases, although the frequency of ossicular anomalies is better to be evaluated and compared in different areas of Iran, and other countries. [ABSTRACT FROM AUTHOR]

Multiple Sclerosis (MS) is a demyelinating disorder of Central Nervous System. It involves 8th cranial nerve and its central nuclei and is an uncommon cause of the sensorineural hearing loss. For determining the prevalence of hearing loss (HL) especially retrocochlear type in MS, a cross-sectional study was designed using Pure-Tone Audiometry (PTA), Otoacustic Emissions (OAEs), Auditory Brainstem Responses (ABRs) compared with the control group. Data were analyzed by Qui² & Fischer exact test in SPSS 17 software. Among 60 patients (44 women & 16 men) and 38 controls (27 women & 11 men) with a mean age of 29.9±9.8 and 31.4± 8.3 years, 12.5% of case ears and 3.9% of the control ears had abnormal PTA (P= 0.043). Frequency of abnormal high frequency-PTA and two modalities of OAEs were not significantly different between case and control ears. The means of overall correlation were 75.9±23.8 in cases and 70.0±27.2 in controls (P= 0.111). 20% of case ears, and 9.2% of the control ears had abnormal ABRs (P= 0.044). The absolute latencies of waves I, II & V had not significant difference, but 10% and 11.7% of case ears and 1.3% & none of the control ears had increased inter peak latencies of I-III, and III-V respectively (P<0.05). 6.7% of case ears and 2.6% of control ears had retrocochlear abnormality (P=0.181). In conclusion, HL is more common in MS patients, especially when determined by using PTA and ABR. [ABSTRACT FROM AUTHOR]

Introduction: High prevalence of rhinoplasty in the community and lack of structured studies about its minor skin and soft tissue complications, point out the necessity of performing precise and comprehensive studies. The aim of this study was to determine the frequency of minor cutaneous and soft tissue complications of rhinoplasty. Materials and Methods: 110 patients (30 Male and 80 Female, Mean age: 26.3± 6.8) participated in this study. Before surgery all of them were checked for having each of intended complications, and 1 and 3 months after the surgery, they underwent serial visits for monitoring skin & soft tissue complications. The software used for data analysis was SPSS ver.16. Results: Acne exacerbation was seen in 27% of cases in first post-surgical visit. Nasal tip paresthesia was the most frequent complication in both postsurgical visits (49.6% in first and 36.3% in second visit), followed by eyebrow loss (31.8%), complaint of increased yawning (31.8%), periorbital hyperpigmentation (21.8%) in first visit, and, hyperpigmentation (19.1%), complaint of increased yawning (10%) and surgical site scar (7.2%) in second visit respectively. The frequency of complications was highest in younger than 25 year old age group. Conclusion: Having knowledge about these complications helps us to know which of them needs prompt medical intervention and which of them will resolve with time and just needs giving reassurance to the patient. [ABSTRACT FROM AUTHOR]

Background: Migraine and allergic rhinitis (AR) are two common causes of headache and facial pain that inflammatory mediators with vasoactive function play important roles in both of them. The aim of this research was to determine the prevalence of migraine in AR patients. Materials and Methods: In a cross-sectional comparative study performed from June to December 2010 in patients with AR sign and symptoms referred to ear, nose, throat (ENT) clinic of a university hospital in Iran-Rasht, 46 patients with positive skin prick test were compared with 60 subject without AR signs and symptoms and with negative skin test. In both the groups, history of migraine according to IHS (International Headache Society ) criteria were investigated. Analysis of data was performed by chi-sqaure and Fisher exact test by using SPSS16. Odds ratio were estimated for determining the chance of migraine in AR. Results: In case group (14 male, 37 female; mean age: 31.17 Ѓ} 8.31 years) and control group (23 male, 37 female; mean age: 37.58 Ѓ} 12.63 years), the prevalence of migraine was 37% and 5%, respectively. The differences in prevalence of migraine and migraine without aura between cases and controls were significant (P = 0.001). The chance of migraine in AR was 8.227 folds (95% CI: 2.38-28.42). In subjects older than 40 years old, the difference of prevalence of migraine was significant, contrary to subjects younger than 30 years old and between 30 and 39 years old. Conclusions: There is a correlation between migraine especially without aura and AR and this correlation is more powerful with increasing age. [ABSTRACT FROM AUTHOR]

Background: Migraine and allergic rhinitis (AR) are two common causes of headache and facial pain in which inflammatory mediators with vasoactive function play important roles. This study aimed to determine the frequency of migraine in AR patients. Methods: In a case-control study performed from June to December 2010 in patients referred to ear, nose and throat (ENT) clinic of a university hospital in Rasht, Iran, 46 AR patients with positive skin prick tests were compared with 60 subjects without AR signs and symptoms and negative skin tests. In both groups, history of migraine was assessed according to IHS (International Headache Society) criteria. Data was analyzed by chi-square and Fisher's exact tests in SPSS17. Findings: The case group included 14 male and 32 female patients with a mean age of 31.17 ± 8.31 years. In addition, 23 male and 37 female individuals with a mean age of 37.58 ± 12.63 years constituted the control group. The prevalence of migraine in the case and control groups was 37% and 5%, respectively. The differences in the prevalence of migraine and migraine without aura between cases and controls were significant (P = 0.001 for both conditions, odds ratio for migraine = 11.244, 95% CI: 2.428-53.76). In contrast to individuals over 40 years old, in subjects younger than 30 and those between 30-39 years old, the difference in the prevalence of migraine (with and without aura) was not significant. Conclusion: The prevalence of migraine, especially without aura, in allergic patients is higher than non-allergic subjects and this correlation is more significant with increasing age. [ABSTRACT FROM AUTHOR]

Anosmia following head trauma is relatively common and in many cases is persistent and irreversible. The ability to objectively measure such a decline in smelling, for both clinical and medicolegal goals, is very important. The aim of this study was to find results of brain Single Photon Emission Computed Tomography (SPECT) in anosmic subjects after closed head trauma. This case-control cross sectional study was conducted in a tertiary referral University Hospital. The brain perfusion state of nineteen anosmic patients and thirteen normal controls was evaluated by means of the SPECT with 99mtc- ECD infusionbefore and after olfactory stimulation. The orbitofrontal lobe of the brain was assumed as the region of interest and changes in perfusion of this area before and after the stimulations were compared in two groups. The mean of brain perfusion in controls before and after the stimulation was 8.26% ± 0.19% and 9.89% ± 0.54%, respectively (P < 0.0001). Among patients group, these quantities were 7.97% ± 1.05% and 8.49% ± 1.5%, respectively (P < 0.004). The difference between all the measures in cases and controls were statistically significant (P < 0.0001). There were no differences in age and sex between two groups. The brain SPECT is an objective technique suitable for evaluating anosmia following the head trauma and it may be used with other diagnostic modalities. [ABSTRACT FROM AUTHOR]

Background: Lipocalin-2 (LCN2) deregulation has been reported in several types of cancer and is implicated in the proliferation, migration, angiogenesis, and progression of tumors. However, its aberrant expression has been rarely studied in nasopharyngeal carcinoma (NPC). In the present study, we investigated the expression of LCN2 in NPC patients. Methods: In this descriptive cross-sectional study, 29 NPC and 20 non-cancerous control paraffin pathology blocks were obtained from the seven-year (2011 to 2018) archive of Razi Laboratory in Rasht, Iran. LCN2 mRNA expression was evaluated through quantitative real-time PCR. In addition, immunohistochemistry was performed to evaluate LCN2 expression at the protein level. The fold change value and total immunostaining score (TIS) were applied for quantitative evaluation. The nonparametric Mann-Whitney U test and Fisher's exact test were used through GraphPad Prism 8.3.0 software. P<0.05 was considered statistically significant. Results: Our results revealed that LCN2 mRNA and protein levels in NPC tissues were significantly higher than control tissues (P=0.028 and P=0.002, respectively). At the protein level, 65.51% (19/29) of NPC patients were categorized as having high LCN2 expression (TIS>3) and 34.47% (10/29) as low expression (TIS≤3). While in the control group, 25% (5/20) of subjects represented a high expression of LCN2 (TIS>3), and 75% (15/20) showed no or weak expression (TIS≤3). No significant correlation was found between the overexpression of LCN2 at the protein level and the demographic features of the patients. Conclusion: Our findings suggest that LCN2 might be considered a potential new diagnostic marker for NPC. However, this warrants further studies. [ABSTRACT FROM AUTHOR]

Objectives: 2019 novel coronavirus disease (COVID-19) infection is commonly associated with olfactory dysfunctions, but the basic pathogenesis of these complications remains controversial. This study seeks to evaluate the value of magnetic resonance spectroscopy (MRS) in determining the molecular neurometabolite alterations within the main brain olfactory areas in patients with COVID-19-related anosmia., Methods: In a cross-sectional study, seven patients with persistent COVID-19-related anosmia (mean age: 29.57 years) and seven healthy volunteers (mean age: 27.28 years) underwent MRS in which N-acetyl-aspartate (NAA), choline (Cho), creatine (Cr), and their ratios were measured in the anterior cingulate cortex, dorsolateral prefrontal cortex, orbitofrontal cortex (OFC), insular cortex, and ventromedial prefrontal cortex. Data were analyzed using TARQUIN software (version 4.3.10), and the results were compared with an independent sample t -test and nonparametric Mann-Whitney test based on the normality of the MRS data distribution., Results: The mean duration of anosmia before imaging was 8.5 months in COVID-19-related anosmia group. MRS analysis elucidated a significant association between MRS findings within OFC and COVID-19-related anosmia ( P disease  < 0.01), and NAA was among the most important neurometabolites ( P interaction  = 0.006). Reduced levels of NAA ( P  < 0.001), Cr ( P  < 0.001) and NAA / Cho ratio ( P  = 0.007) within OFC characterize COVID-19-related anosmia., Conclusions: This study emphasizes that MRS can be illuminating in COVID-19-related anosmia and indicates a possible association between central nervous system impairment and persistent COVID-19-related anosmia., Competing Interests: The authors declare no conflict of interest., (© 2023 The Authors. World Journal of Otorhinolaryngology ‐ Head and Neck Surgery published by John Wiley & Sons Ltd on behalf of Chinese Medical Association.)

Background: Lipocalin-2 (LCN2) deregulation has been reported in several types of cancer and is implicated in the proliferation, migration, angiogenesis, and progression of tumors. However, its aberrant expression has been rarely studied in nasopharyngeal carcinoma (NPC). In the present study, we investigated the expression of LCN2 in NPC patients., Methods: In this descriptive cross-sectional study, 29 NPC and 20 non-cancerous control paraffin pathology blocks were obtained from the seven-year (2011 to 2018) archive of Razi Laboratory in Rasht, Iran. LCN2 mRNA expression was evaluated through quantitative real-time PCR. In addition, immunohistochemistry was performed to evaluate LCN2 expression at the protein level. The fold change value and total immunostaining score (TIS) were applied for quantitative evaluation. The nonparametric Mann-Whitney U test and Fisher's exact test were used through GraphPad Prism 8.3.0 software. P<0.05 was considered statistically significant., Results: Our results revealed that LCN2 mRNA and protein levels in NPC tissues were significantly higher than control tissues (P=0.028 and P=0.002, respectively). At the protein level, 65.51% (19/29) of NPC patients were categorized as having high LCN2 expression (TIS>3) and 34.47% (10/29) as low expression (TIS≤3). While in the control group, 25% (5/20) of subjects represented a high expression of LCN2 (TIS>3), and 75% (15/20) showed no or weak expression (TIS≤3). No significant correlation was found between the overexpression of LCN2 at the protein level and the demographic features of the patients., Conclusion: Our findings suggest that LCN2 might be considered a potential new diagnostic marker for NPC. However, this warrants further studies., Competing Interests: None Declared., (Copyright: © Iranian Journal of Medical Sciences.)

Introduction: Despite recent progress in treatment of burn injuries, head and neck burn and its complications is still considered a challenge. This study aimed to evaluate the baseline characteristics and outcomes of patients with head and neck burn., Methods: In this retrospective cross-sectional study, the medical profiles of patients with head and neck burn referring to a burn care center during 2 years were reviewed and analyzed regarding the baseline characteristics and outcomes of participants., Results: 392 (17.97%) cases suffered from head and neck burns. The mean burn percentage of participants was 29.31 ± 24.78, and 126 (32.14%) cases required tracheal intubation. There was a direct correlation between length of hospital stay and the degree of burn (p < 0.001). The length of hospitalization for patients burned by electricity was longer than those burned by other mechanisms (p = 0.003). There was a significant correlation between degree of burn and abnormal laryngoscopy findings (p = 0.036), developing acute respiratory distress syndrome (ARDS) (p < 0.001) and pneumonia (p < 0.001), need for mechanical ventilation (p < 0.001), and mortality rate (p < 0.001)., Conclusion: Based on the findings of the present study, the prevalence of head and neck burn injuries was about 18% and 32.14% of these cases required airway management. 19 (4.85%) cases developed ARDS, 41 (10.46%) developed pneumonia, and 50 (12.76%) cases died. There was a significant correlation between degree of burn and abnormal laryngoscopy findings, developing ARDS and pneumonia, need for mechanical ventilation, and mortality rate., Competing Interests: None.

Background: There is challenge to find an effective treatment for tinnitus. Few studies were done on the effects of acupuncture on tinnitus. This study evaluated the effect of acupuncture on chronic non-pulsatile tinnitus., Methods: This randomized double-blind clinical trial was conducted from December 2014 to September 2015 . Patients suffering from chronic non-pulsatile tinnitus were randomly allocated into two groups: acupuncture vs. placebo. They were treated in 15 sessions and at the end of the fifteenth sessions and 3 weeks after completion of the treatment, visual analog scale (VAS) for tinnitus loudness and tinnitus severity index (TSI) questionnaires were completed., Results: The case group included 26 males and 18 females, and in the control group there were 27 males and 17 females: with mean age of 49.11±1.07 and 55.20±8.33 years, respectively (p=0.005). TSI and VAS before treatment were 43.84±2.81 and 9.56±0.43 in cases and 43.52±2.94 and 9.54±0.45 in controls, respectively. Both measures improved after 15 sessions in cases to 24.82±1.04 and 2.88±0.33, and to 33.16±1.24 and 7.86±0.23 in controls. The changes of TSI and VAS were significant in all groups (p<0.001). TSI and VAS in acupuncture group were lower than placebo group in each session (p<0.001), except TSI in the tenth session (p=0.392)., Conclusions: Acupuncture is effective in reducing the loudness and severity of tinnitus and can be a useful treatment for nonpulsatile chronic tinnitus., Competing Interests: The authors declare no conflict of interest regarding the present study.

Introduction: It seems that diabetes mellitus (DM) can affect the auditory system due to neuropathy, micro-vascular complications, and hearing cell damage during hyperglycemic states. In the current study, we aimed to compare hearing status in patients with type 2 DM (T2DM) according to their blood-sugar control status., Materials and Methods: This cross-sectional study was carried out in 104 patients with T2DM attending the diabetic clinics of Guilan University of Medical Sciences within a period of 1 year (2014-2015). One group consisted of 52 patients with poor control and the other consisted of patients with moderate-to-good control (according to glycated hemoglobin [HbA1c] level). All subjects underwent pure tone audiometry (PTA) and distortion product otoacoustic emission (DPOAEs) assessments. A hearing threshold higher than 20 dB and a signal-to-noise ratio ≤3 in each frequency were considered abnormal., Results: In PTA, poorly controlled patients showed more frequent hearing loss compared with the well-controlled group, especially at higher frequencies (8 kHz: 67.3% vs 46.2% [P=0.029]; 10 kHz: 46.2% vs 21.2% [P=0.025]). Also, patients in the poorly controlled group had worse cochlear function according to the DPOAE test (4 kHz: 32.7% vs 17.3% [P= 0.002] and 8 kHz: 70.6% vs 40.4% [P=0.006])., Conclusion: DM and poor control status of diabetes can affect hearing sensation and cause hearing loss, especially at high frequencies. According to our findings, it seems that diabetic patients with a duration of diabetes >10 years, diabetic complications, poor control status or comorbidities should undergo both endocrine and audiologic follow-up to prevent greater sensory neural hearing loss.