role of Human papilloma virus [HPV] genotyping in recurrent respiratory papillomatosis in Rasoul Akram Hospital

The most common laryngeal mass in children is recurrent respiratory papillomatosis [RRP]. Studies have attempted to correlate viral typing and its aggressiveness. 29 patients with histologically confirmed RRP enrolled in adjuvant therapies. Patients underwent several surgical interventions. HPV genotyping demonstrated 45% HPV-6 and 55% HPV-11. The mean age at the first surgical intervention was 52.39 months [SD=102.28] [range from 4 months to 426 months]. The mean number of surgical intervention was 10.39 [SD=7.76] [range from 2 to 30]. The mean time of surgical intervals was 4.63 months [SD=4.02] [range from 2 to 24 months]. In fourteen patients [48%] tracheotomy was done. All patients who had tracheotomy received alpha-interferon. One of our cases was a male who had pulmonary extension with HPV-6. A review of patients with RRP was regarding to HPV genotyping and need for adjuvant therapy and tracheostomy. Mean number of surgical procedure was 10/40 and nearly fourteen patients [48%] need to tracheotomy. The clinical differences between HPV6 and HPV11 disease may not be accurately predictable. Patients with less age and with HPV-11 seemed to have more severe problems, but these differences were not statistically significant which needs much more investigations for reasonable starting point of evaluation for these differences

Effectiveness of adenoidectomy on tympanostomy tubes retention duration

The children with middle ear effusion need repeated re-tympanostomies. Adenoidectomy is an effective surgical intervention in the management of chronic otitis media with effusion in conjunction with insertion of tympanostomy tubes [TTs]. To find out whether TTs in different positions decrease the rate of re-tympanostomies study was done. The present study retrospectively evaluated the effectiveness of adenoidectomy on retention of Shepard TTs in antero-inferior quadrant [AIQ] and postero-inferior quadrant [PIQ] with chronic, persistent or recurrent otitis media. Eighty-five children [one-hundred and seventy ears] underwent bilateral myringotomy and TTs placement with and without adenoidectomy with informed consent. According to the TTs retention duration rate, there was a significant difference between adenoidectomy and non-adenoidectomy groups in AIQ. It was concluded that TTs placement in the AIQ in conjunction with adenoidectomy showed better improvement and prolonged ventilation. This study suggests that adenoidectomy is an effective surgical intervention in the management of otitis media especially when it is performed in conjunction with insertion of TTs. This significantly decreases tube extrusion rate especially in an AIQ, which might be due to improving eustachian tube function that consequently reduces repeated otitis media

[Effects of voice therapy on vocal acoustic characteristics in patients with vocal cord nodules]

Vocal cord nodule is one of the voice disorders causes hoarseness and breathy voice. Voice therapy is one of the treatment approaches. We aimed to find out the effects of voice therapy on vocal acoustic characteristics in these patients. In this case series, five women with vocal nodule [14 to 45-year-old] participated in a 9- week voice therapy program developed by Boone. Vocal hygiene and voice practices were measured every day using a questionnaire. Moreover, structure and movements of vocal folds were examined using videolaryngostroboscope by a laryngologist before and after voice therapy to evaluate the effectiveness of program. For collecting voice samples we used sustained /‘/ in comfortable loudness for all patients and data were analyzed using Speech Studio. After voice therapy, fundamental frequency in four of five subjects were decreased but it was not significant [p=0.225]. However, jitter in all of five subjects was significantly decreased [p=0.043]. After voice therapy, shimmer in three of five subjects were decreased that was not significant [p=0.345]. Voice therapy can be used for the remedy of acoustic vocal characteristics and elimination or contraction of vocal cord nodule

Evaluation of Helicobacter pylori and laryngeal lesions in patients undergoing direct laryngoscopy and biopsy in Taleghani hospital between 2008 and 2009

Few studies have evaluated association of Helicobacter pylori with benign and malignant laryngeal lesions. The aim of this study was to evaluate the coexistence of Helicobacter pylori with laryngeal lesions in patients with laryngeal growths, admitted in Taleghani hospital. In this cross-sectional study, all patients referred to ENT ward of Taleghani hospital for direct laryngoscopy and biopsy were evaluated. Biopsied specimens were sent for histologic evaluation and PCR [Polymerase Chain Reaction] to the Research Center for Gastroenterology and Liver diseases. PCR was used to detect Helicobacter pylori in biopsied specimens. Fifty-nine patients with a mean age of 46.1 +/- 18.3 years were evaluated. 27 patients had malignant laryngeal lesions and 32 had benign laryngeal lesions. The frequency of Helicobacter pylori in the malignant and benign group was 29.6 and 15.6 percent, respectively; the difference was statistically non-significant. However, a correlation was found between malignant laryngeal tumors with male gender, alcohol consumption, smoking and opioid usage. Findings of this study failed to find an association between the presence of Helicobacter Pylori and laryngeal cancers

Peripheral neuropathy in type 2 diabetes mellitus in Isfahan, Iran: prevalence and risk factors

To estimate the prevalence and risk factors of peripheral neuropathy [PN] in people with type 2 diabetes mellitus. 810 patients with type 2 diabetes [289 male and 521 female] from Isfahan Endocrinology and Metabolism Research Centre outpatient clinics, Iran, were examined. Part of the examination included an assessment of neurological function including neuropathic symptoms and physical signs, and nerve conduction velocity. The prevalence of PN was 75.1% [95% confidence interval [CI] 72.1, 78.0]. Peripheral neuropathy was associated with age, proteinuria, and duration of diabetes, insulin-treatment, and presence of retinopathy and ischaemic heart disease [IHD]. The age-adjusted prevalence rate of PN was 78% higher among patients with IHD, 64% higher among patients with any retinopathy, 66% higher among insulin-treated type 2 diabetes, and greater with duration of diabetes. Using a stepwise binary logistic regression model, age, duration of diabetes and proteinuria were significant independent predictors of PN. PN is a common complication in this population of Iranian type 2 diabetic patients. It increases with age, duration of diabetes and proteinuria