validity of computed tomography in complicated chronic otitis media

We assessed the validity of computed tomography [CT] in the diagnosis of complicated chronic otitis media [COM]. The findings obtained from a pre-operative high resolution CT of temporal bone including coronal and axial views of 20 patients with complicated COM were compared to their intraoperative findings. In our study, CT was helpful in determining the anatomy of the mastoid and could accurately predict the mastoid air cell aeration, size and status of ossicles, presence of lateral semicircular canal [SCC] fistula and post-auricular fistula [All sensitivities equal to 100%]. But it overdiagnosed the erosion of tegmen [positive predictive value of 50%]. CT was unable to distinguish between cholesteatoma and fluid [abscess or effusion] and granulation tissue or polyps and was also unable to correctly reveal the facial nerve dehiscence and had a low sensitivity for showing erosion of facial canal [50%] and sigmoid sinus [60%] Because most complications resulting from cholesteatoma are caused by bony erosions, CT is helpful in determining the complications of COM. CT can accurately predict the extent of disease and is helpful in detection of some complications such as fistula of Lateral Semicircular Canal [LSC], erosions of dural plate and ossicular erosions. However, it is unable to distinguish between cholesteatoma, mucosal disease and fluid, and little it did contribute to detecting the facial nerve course and dehiscence. It cannot also be used for the diagnosis of the sigmoid sinus problems which could be related to no contrast administration in our study

[ effects of garlic topical gel [5%] in the treatment of alopecia areata]

Alopecia areata is the rapid onset of total hair loss in a sharply defined round area. No definite cause is known for this disease but stress is an effective factor. Different treatments are available but no cure is yet known. The purpose of this study is to determine the efficacy of garlic gel in treatment of alopecia areata. The method of study is placebo controlled. The study was performed during summer 2004-5. The subjects were recruited from dermatology clinics in the city of Sari, according to inclusion criteria. They were randomly divided into 4 blocks and received gel and placebo. Garlic gel was used twice dayly with topical corticosteroid. The results were compared together after 3 months. The data were analyzed by ANOVA and Tuky-test using SPSS program. Twenty patients were given the garlic gel and placebo was administered to the other 20 patients. The average age of the patients [55% male] was 24 _ 15. Scalp was the most common affected area in patients [72.5%] and majority of them had one patch [70%]. Positive familial history was noted in 22.5% of the patients and 25% of them had the atopic. Stress was observed in 35% of the patients. There was no difference in decreasing the size of patches in the first two months, between the two groups. However, the increase in the number of hair between the two groups were significant in the third month[P<0.05]. The garlic gel can stimulate hair growth in patients with Alopecia areata. Therefor this effective and low cost treatment is recommended particularly for limited forms of the disease

Very rare case of foreign body in the coronary artery

A 56year old man was admitted to our center for further evaluation of typical chest pain of ten months' duration. Selective coronary angiography was done and showed a sewing needle-like foreign body which was lying in very close proximity to the anatomic location of the right coronary artery. At operation two pieces of sewing needles were removed, one from the coronary sinus and the other from the right coronary artery before the crux

Envenimations scorpioniques dans le gouvernorat de Sidi Bouzid: etude epidemiologique et organisation de la lutte

The medical consequences of scorpion x bites including death, which occur principally in the hot summer season, are a common problem in the region of Sidi Bouzid. The seriousness of a bite is affected by various factors, including young age, the site, especially near the head or neck, and a delay in treatment. In the campaign against this problem, additional staff [recruited for the scorpion season] and health education a key- role