Idiopathic subglottic stenosis in a pregnant woman: successful treatment with dilatation and Nd: YAG laser ablation

Idiopathic subglotic stenosis [ISS] is a rare progressive condition affecting young females. The cause is unknown and in some reports relation with anti-cytoplasmic antibodies [ANCA] and gastroesophageal reflux disease [GERD] has been reported. Surgical resection of stenotic area or dilatation with laser ablation are the main treatment options. We report a case of ISS in a five-month pregnant woman with gradual deterioration who was treated with dilatation by rigid bronchoscopy and laser ablation of excessive tissue

Practice of deep vein thrombosis prophylaxis in teaching hospitals of Tabriz

Deep Vein Thrombosis [DVT] and Pulmonary Thromboembolism [PTE] are one of the frequently missed and lethal complications in admitted patients. Unfortunately, in spite of the presence of consensus about prevention of DVT, these guidelines are not applied in most hospitals. Death rates from DVT and PTE are more than those of road accidents and breast cancer. Our study aimed to analyze the situation of DVT/PTE prevention in hospitals of Tabriz. Based on 75000/ year admission, we studied the records of 17 teaching wards in 7 hospitals systematically. At least 50 records from each ward were reviewed. Records with insufficient data; admissions of less than 3 days; heparin treated cases; uremic and cirrhotic patients; those with bleeding tendencies, and ENT, ophthalmology, pediatric wards were excluded. 1557 records were collected, and risk of DVT [low-moderate-high-very high] along with appropriate prevention method was stratified according to ACCP 1998 guideline for surgical ward. For stratification of risk factors in medical wards, comparable rate of prevalence of DVT/PTE was used for every medical condition. Highest rate of DVT prevention was related to cardiology unit [63.4%] and lowest rate to thoracic surgery unit [2.7%]. Appropriate prevention methods were related to cardiology [73.1%], pulmonary ICU [51.4%], and gynecology [42.3%]. Inappropriate methods were related to neurology ICU, neurosurgery, and orthopedic wards [0%]. This study shows that in spite of the presence of guidelines for prevention of DVT, and the importance of this in decreasing costs and mortalities, application of appropriate method in most wards is far from reality, and continuous learning of physicians about prevention of DVT and regular control of medical records by medicare is strongly recommended in order to reach a good endpoint