[Oculomotor function in idiopathic Parkinsonian patients]

Parkinson could be regards the most prevalent degenerative disorder in the central nervous system. In addition to neuromuscular disorders, some degree of oculomotor dysfunction may be observed in these patients. The assessment of oculomotor system function may provide a viewpoint about the balance status of Parkinosonian patients and cold be regarded as an appropriate tool for the extent of movement disorders. The purpose of this study was the evaluation of oculomotor system in patients with idiopathic Parkinson's disease. Certainly, better understanding of mechanisms involved in this disorder, may help in designing rehabilitation programs and quality of life increment in these patients. In an analytic cross-sectional study, 30 patients [M:18, F: 12] with idiopathic Parkinson's disease and 30 [M: 20, F: 10] normal subjects, aged 35-70 years, were evaluated. Gain and phase of smooth pursuit eye movements [during horizontal and vertical situations] were recorded in 0.2 Hz velocity for all participants. Independent T and man-Whitney U tests [when the data distributions were not normal] were used for the comparison of mean gain and phase of responses between groups. Data analysis was carried out by SPSS 15. The average of pain, except for horizontal right eye condition, in normal subjects was significantly higher than patients with Parkinson's disease [P < 0.05]. Additionally, the average of phase, except for horizontal right eye condition, in patients with Parkinson's disease was significantly increased compared to normal subjects [P<0.01]. Serious oculomotor system dysfunction, both in horizontal and vertical situations, in idiopathic Parkinsonian patients may representative of dopaminergic control decrement in these patients

[ relation between maxillary constriction and hearing loss]

Maxillary constriction and high palatal vault can change the location of soft palate and may cause Eustachian tube dysfunction and even stenosis. The purpose of this study was to evaluate the relationship between maxillary constriction and conductive hearing loss. This case-control study included one hundred twenty patients whom were divided into two equal groups. The patients' ages ranged from 7 to 40 years. Hearing level was measured in all patients with a digital audiometer. The control group consisted of sixty participants with normal hearing level [under 15 db], wherease patients who had the hearing level of more than 15 db were the cases with conductive hearing loss. Then maxillary constriction was examined in both groups according to skeletal posterior cross bite and high palatal vault. These two groups were compared applying of chi-square test. This study showed that maxillary constriction was seen in 7 patients [11.7%] in control group and 19 patients [31.7%] in case group [P < 0/05]. People suffering from hearing loss were faced with maxillary constriction 3.5 times more than others. There is a significant relationship between maxillary constriction and conductive hearing loss. Thus, it is recommended that to prevent from hearing loss, maxillary constriction should be treated appropriately

[Accuracy of cortical evoked response audiometry in estimating normal hearing thresholds]

Cortical Evoked Response Audiometry [CERA] refers to prediction of behavioral pure-tone thresholds [500-4000 Hz] obtained by recording the N1-P2 complex of auditory long latency responses. CERA is the preferred method for frequency-specific estimation of audiogram in conscious adults and older children. CERA has an increased accuracy of determination of the hearing thresholds of alert patients with elevated hearing thresholds with sensory hearing loss; however few publications report studies regarding the use of CERA for estimating normal hearing thresholds. The purpose of this research was to further study the accuracy of CERA in predicting hearing thresholds when there is no hearing loss. Behavioral hearing thresholds of 40 alert normal hearing young adult male [40 ears] screened at 20 dB HL in 500-8000Hz, predicted by recording N1-P2 complex of auditory evoked long latency responses to 10-30-10 ms tone bursts. After CERA, pure tone audiometry performed by other audiologist. All judgments about presence of responses performed visually. Stimulus rate variation and temporary interruption of stimulus presentation was used for preventing amplitude reduction of the responses. 200-250 responses were averaged near threshold. In 95% of the hearing threshold predictions, N1-P2 thresholds were within 0-15 dB SL of true hearing thresholds. In the other 5%, the difference between the CERA threshold and true hearing threshold was 20-25 dB. The mean threshold obtained for tone bursts of 0.5, 1, 2 and 4 kHz were 12.6 +/- 4.5, 10.9 +/- 5.8, 10.8 +/- 6.5 and 11.2 +/- 4.1 dB, respectively, above the mean behavioral hearing thresholds for air-conducted pure tone stimuli. On average, CERA has a relatively high accuracy for the prediction of normal hearing sensitivity, comparable to that of previous studies performed on CERA in hearing-impaired populations

[Halitosis and its treatment]

Halitosis is a general term used to describe an unpleasant offensive odor emanating from the oral cavity. Under normal conditions, breathing has a special and not a bothering odor, which is called human odor. Around 90% of all the causes of bad breath originate from the oral cavity, and more specifically, it has been reported that around 40% come from the dorso-posterior region of the tongue. Moreover, nonoral pathologic conditions, including upper and lower respiratory tract and gastro-intestinal infections, as well as some metabolic diseases, have also been identified as halitosis-inducing factors. Oral cavity malodor can be attributed to a variety of products arising from bacterial amino acids' metabolism. These metabolites include many compounds, such as indole, skatole and volatile sulfur compounds, like methyl mercaptan, hydrogen sulfide, dimethyl sulfide, which are the main components of bad breath originating from the oral cavity. The microorganisms that contribute to halitosis include gram negatives, anaerobes, klebsiella, and bacteroids. Local pathologic factors like poor oral hygiene, chronic gingivitis, dental caries, dental plaques, malignancies of the oral cavity and surrounding tissues, tonsillar chronic infections, foreign bodies in tonsils or oral cavity, fissured tongue and sino-nasal diseases can also induce halitosis. In addition, systemic pathologic etiologies like lower respiratory tract infections, gastro-intestinal disorders, blood dyscrasias, diabetes, liver cirrhosis, renal failure, vitamin deficiencies, especially vitamin C deficiency, and some drugs can cause halitosis. Local non-pathologic factors, such as smoking, dental prosthesis, saliva stasis, and systemic non-pathologic ones, like pregnancy, menstruation, menopause, fasting, old age, and some foods can bring about malodorous breath. Old age, salivary gland aplasia, diabetes, menopause, bad oral and dental hygiene, and spices can cause mouth dryness and reduce salivary flow and mouth washing, hence leading to a foul-smelling mouth. Complete and close physical examination and history taking can guide the physician toward the diagnosis and help to find the exact cause of halitosis. Bad odors of short time duration are mainly caused by infections, severe systemic diseases, foreign bodies, or recent drug therapy. In contrast, majority of long-lasting bad odors are due to poor oral hygiene, malignancies of the oral cavity or surrounding tissues, respiratory tract, or bronchiectasis. Intake of some foods and sleeping may result in intermittent halitosis. Eradication of halitosis inducing factors is the first step toward problem solving. Besides, care of the oral hygiene, teeth, gums, tongue brushing, and dental flossing help to overcome bad breath originating from the oral cavity

Hydatid disease of the submandibular gland

Echinococcosis is a tissue infection of the human caused by the larval stage of Echinococcus granulosus or E. multilocularis. Hydatid cyst of the head and neck region is uncommon and involvement of the salivary glands, especially the submandibular gland, is very rare. In this article, a case of submandibular gland hydatid cyst is reported in a patient who presented with swelling of this area of 5 months' duration. Examination revealed a soft, nontender, mobile mass measuring 7x5 cm. Chest x-ray and abdominal ultrasonography were normal. Excision of the mass was performed and pathologic examination revealed a hydatid cyst of the submandibular gland