Myxoid Neurofibromas of the External Ear Canal: A Case Report

Myxoid neurofibroma is benign tumours of perineural cell origin that arise from elements in the peripheral nervous system. We report a case of a 60-year-old female patient presented with history of right ear mass which was slowly growing. Her primary complaint was cosmetic deformity but hearing loss was also present. The mass was excised and histologically revealed a myxoid neurofibroma. To the authors’ knowledge, this is the first time that a myxoid neurofibroma arising from external auditory canal is reported. It should be included in the differential diagnosis of a mass originating from this location.

Frequency of djinnati syndrome among inpatient admissions at baharan psychiatric hospital in Zahedan, Iran

A culture-bound syndrome common in Baluchistan is Djinnati that is classified as trance and possession state, a sub-class of dissociative disorders NOS, in DSM IV-TR. The present study aims to determine the frequency of Djinnati syndrome among in-patients at Baharan psychiatric hospital in Zahedan, Iran. In this descriptive study, the statistical community includes all patients [N=773] who were admitted in Baharan psychiatric hospital during a 6 months period. After considering the inclusion and exclusion criteria, 150 subjects [61 males and 89 females] were selected. Semi-structural interview and Dissociative Experience Scale [DES] questionnaire were performed for them. Spearman's rank correlation coefficient, chi[2], and t-tests were employed for analysis of data in SPSS-18. Frequency of Djinnati syndrome among patients admitted in this referral psychiatric hospital was 4.1% and this syndrome showed a significant dominance in female sex [M/F=1/3]. There was also a positive and significant correlation between child abuse and dissociative experiences including Djinnati. The study has shown that dissociative disorders NOS, in the form of trance and possession states [such as Djinnati], are not rare especially in the eastern parts of Iran and among poor and young women. It is important to define Djinnati syndrome in this region and prepare medical students and psychiatric residents for diagnosing and managing this condition. Its relationship with child abuse should be considered in preventive medicine

How to test normality distribution for a variable: a real example and a simulation study

Many commonly used statistical methods require that the population distribution be nearly normal. Unfortunately, in some papers the one-sample Kolmogorov-Smirnov test has been used for testing normality while the assumptions of applying this test are not satisfied. To conduct this test, it is assumed that the population distribution is fully specified. In practical situation where the mean and SD of population distribution is not specified in advance, one can use a modification of the K-S test for checking the normality assumption which is called, Lilliefors test. In this paper, we explain the method of computing this test with some common statistical softwares such as SPSS, S-PLUS, R and StatXact and utilize a dermatology dataset from Skin Research Center of Shohada-e-Tajrish hospital to illustrate how the use of the one-sample K-S [with the mean and SD estimated from the sample] instead of its modification can be misleading in practice. We also use Monte Carlo simulation to compare the approximate power of the one-sample K-S test [with the estimated population mean and SD] with Lilliefors test in some common specified continuous distributions. The result indicates that one should not use the one-sample K-S test for assessing the normality assumption in practical situation

[Comparing carotid intima-media thickness in type 2 diabetes between patients with and without retinopathy]

Microangiopathy and macroangiopathy frequently coexist in type 2 diabetes mellitus [T2DM]. Both types of the vascular complications share traditional risk factors but it is not clear whether the presence of microangiopathy, such as diabetic retinopathy, constitutes a predictor of atherosclerosis in carotid arteries in patients with the disease. In this study we looked for the association between diabetic retinopathy and intima-media thickness in carotid arteries of patients with T2DM. In this case-control study we examined 100 consecutive patients with T2DM in Rasoul Akram Hospital in Tehran, Iran during 2009-2010. We assessed intima-media thickness of carotid arteries by ultrasonography. All patients underwent ophthalmo-logic examination. Diabetic retinopathy was found in 50 [50%] patients. Intima-media thickness was higher in patients with diabetic retinopathy than those without it [0.77 +/- 0.17 mm vs. 0.71 +/- 0.2 mm, respectively, P=0.041]. Moreover, intima-media thickness was more prevalent in patients with proliferative diabetic retinopathy than patients with non-proliferative form of the disease [0.87 +/- 0.16 mm vs. 0.68 +/- 0.1 mm, respectively, P<0.001]. Diabetic retinopathy seems to be associated with increased intima-media thickness of carotid arteries in T2DM. It may be a common denominator of pathogenesis of microvascular complications and atherosclerosis in T2DM. Evaluations of carotid arteries are to be done by non-invasive methods such as color Doppler sonography for screening and preventing prospective cereberovascular accidents in patients with diabetic retinopathy, especially proliferative retinopathy, in routine ophthalmological examination of patients with T2DM

Soluble Fas in pemphigus vulgaris

The Fas/Fas ligand [FasL] system has been recognized as an important pathway for apoptosis induction in cells and tissues. It has recently been shown that skin lesions of pemphigus vulgaris are associated with Fas mediated apoptosis. The aim of this study was to evaluated the level of serum soluble Fas of ten newly diagnosed patients with pemphigus vulgaris. Sera were collected from ten patients with pemphigus vulgaris. Commercial sandwich enzyme-linked immunosorbent assay [ELISA] for quantitative detection of soluble Fas was applied. Patients with mucosal skin involvement had higher median values in contrast to patients with cutaneous involvement. Elevation of soluble Fas in our study may give insights for the pathogenesis of pemphigus vulgaris. Suppression of this underlying mechanism may be an important target for novel therapies and relapse prevention

Does pimecrolimus cream enhance the effect of excimer laser on eyelid vitiligo?

Vitiligo is a cutaneous disorder of pigmentation, for which, there are some proven modalities of treatment. In this study, we evaluated the efficacy of the addition of topical pimecrolimus to 308nm Excimer laser in reducing treatment duration and improving the response rate of eyelid vitiligo, compared with 308nm Excimer laser monotherapy. Fifty two symmetrically localized lesions of eyelid vitiligo in 26 patients were observed. Each of vitiliginous patches was treated with 308nm Excimer laser twice a week for a total of 30 sessions. Topical pimecrolimus 1% cream was applied to the patches of right eyelid[group A lesions] and eucerine cream as a placebo to the left side patches[group B lesions]twice daily, throughout the study. Photographs were taken at baseline, 6 and 15 weeks after starting the treatment. Twenty two patients [44 lesions] completed the study. Repigmentation was appeared in all [100%] of groups A and B lesions. A 75% or more repigmentation was achieved in 17 [78%] of group A versus 14 [64%] of group B lesions. The average number of sessions needed for the appearance of repigmentation was 8 for group A lesions and 12 for group. The repigmentaion of 50% or more in patients with disease duration of 2 years or less and those with more than 2 years duration ere 100% and 59.2%, respectively. Repigmentation rate obtained by the combination therapy of eyelid vitiligo with 308nm Excimer laser and topical Pimecrolimus 1%cream is significantly higher, and obtained in fewer sessions in comparison with 308nm Excimer laser and placebo combination therapy

Selenium in patients with alopecia areata: a case-control study

Autoimmune mechanisms are involved in the etiology of alopecia areata. It is also shown that selenium has some effects on regulation of autoimmune mechanisms.To compare the plasma level of selenium between those with and without alopecia areata. In this case-control study, 29 patients with alopecia areata referred to Razi hospital in Tehran, and 29 persons without this disease were selected consequently. Plasma level of selenium was determined and compared between the groups. The mean age of cases was 24.9 +/- 10.5 and of controls was 29.1 +/- 10.5 years. In both groups 15 [51.7%] patients were males and 14 [48.3%] of them were females. The mean plasma selenium level in cases was significantly lower than what was observed in controls [62.1 +/- 13.3 g/L vs. 88.3 +/- 13.2g/L, P<0.0005]. This study indicated that mean plasma selenium level in patients with alopecia areata was lower than those without this disorder. It is recommended to evaluate the effects of adding selenium to dietary regimen of patients with alopecia areata