[Hearing loss in multiple sclerosis patients]

Multiple sclerosis is one of demyelinating disorder of CNS that is an uncommon cause of the sensorineural hearing loss. This study was done to determine the hearing loss in multiple sclerosis patients. This case-control study was performed on 60 [44 women, 16 men] multiple sclerosis patients and 38 [27 women, 11 men] normal subjects by pure tone audiometery, otoacustic emissions and auditory brainstem responses in Gilan provine, Iran during 2010-11. Data was analyzed by using SPSS-17, Chi-Square and Fischer tests. 12.5% of case and 3.9% of the control ears had abnormal pure tone audiometery [P<0.05]. The frequencies of abnormal HF-pure tone audiometery and two modalities of otoacustic emission did not show any significant differences in two groups. Abnormal autidory brainstem response of ears were observed in 20% and 9.2% of cases and controls, respectively [P<0.05]. 20% of case and 9.2% of the control ears had abnormal auditory brainstem response [P<0.05]. The absolute latencies of waves I, II and V had not significant differences between two groups. Inter peak latencies of I-III and III-V waves were observed in 10% and 11.7% in cases ears and 1.3% and zero percent in controls, respecticely. 6.7% of cases and 2.6% of control ears had retrocochlear abnormality. Hearing loss detected by pure tone audiometery and auditory brainstem response is more common in multiple sclerosis compared to normal population

[Sonographic evaluation of nasal tip skin stickness among patients undergoing rhinoplasty with or without defatting]

Background: Skin thickness has an important role in aesthetic results of rhinoplasty. Currently, some surgeons employ defatting technique to reduce subcutaneous tissues and decrease the thickness of skin during rhinoplasty

Objective: The aim of this study was to compare the nasal tip skin thickness with and without nasal tip skin defatting technique and to further evaluate the long term effects of this technique on rhinoplasty patients by sonography

Methods: In a case-control study, 111 rhinoplasty candidates were evaluated at a university referral hospital in northern Iran during January to August 2010. Before operation, all patients were investigated through physical exams. Later, the skin thickness of the tip and supra tip were measured by sonography. Patients with moderate to thick nasal skin were randomly allocated to case and control groups for defatting. Sonography results of 44 patients, obtained one and 12 months after the surgery, were compared with those found in two groups before the surgery using Wilcoxon test and Repeat Measure test

Findings: A total of 111 patients with mean age of 25.1 +/- 7.6 years including 16 [14.4%] men and 95 [86.6%] women were enrolled. Based on physical examinations, the skin type was thin in 20 [18.9%], moderate in 68 [59.4%], and thick in 23 cases [21.7%]. Considering the sonography results, the skin type was thin in 7 [6.8%], moderate in 83 [80.6%], and thick in 13 cases [12.6%]. There was no significant difference in the thickness of tip and supra tip skin between defatted cases and control group measured before surgery and within the follow-up period

Conclusion: Based on results found through this study, Sonography is a precise instrument in assessing the nasal skin thickness before rhinoplasty. Defatting technique was shown to be of no effect on reduction of skin thickness of tip and supra tip in moderate or thick skins following rhinoplasty

[ relationship between allergic rhinitis and chronic otitis media]

Allergic inflammation in upper airways can act as a predisposing factor for infectious ear diseases. There are some evidences about the role of allergic rhinitis [AR] in chronic otitis media with effusion, but its role in establishing Chronic Supportive Otitis Media [CSOM] has not been clearly shown. To assess the relationship between allergic rhinitis and CSOM in patients referring to Amiralmomenin hospital, Rasht, Iran. 61 adult patients with established CSOM were considered as case group and 58 patients with minor head and neck trauma as control group, they were evaluated for the presence of allergic rhinitis. All case and control group were over 15 years old and underwent skin prick test for 23 common regional aeroallergens. Allergic rhinitis was defined with positive symptoms and signs of AR and positive skin prick test. Allergic rhinitis was diagnosed in 15[26.20%] and 8 [13.80%] of patients and controls, respectively [P=0.065].By logistic regression equation after corroding the age factor and the difference between two groups became significant [x2=0.026, OR=3.27, CI=1.15 - 6.57]. Indoor allergens, especially mites and molds, were the most prevalent allergens among both groups, but Outdoor allergens like grass pollen have a low prevalence. The prevalence of AR in the CSOM patients is more than the controls

[Normal olfaction range of Rasht residents with a new test designed for the region]

An important part of one's information from surrounding environment comes through olfactory system. So its disorders regardless of the reason can lead to a lot of problems. An appropriate diagnostic smell test is needed for determination to the normal range of olfactory sense, and evaluation of patient's complain of hyposmia or anosmia and determination the severity of the problem. It is helpful for follow up and choosing the most effective surgical or medical treatment too. Unfortunately Current used tested for diagnose of factory system disorders are not modified for Iranian population and are difficult to run and interpret. Development of a standard smell test for Iranians and determination of the normal range of olfactory sense in this region. In order to find popular odorous items in the region, 56 well known materials were presented to two hundred, 15-60 years old, normal relatives of patients who came to university based Amir-Al- Momenin hospital. Then 16 materials with the highest scores were selected [based on this consensus] as the test materials. These were: petrol, alcohol, tea, rice, soap, cinnamon, origan, and garlic, onion, washing powder, mint, rose water, lemon juice, olive oil, Vinegar and Vix. Then, these 16 selected materials were presented to 150 people of study group [77 women, 73 men]. All materials were presented in identical containers. Participants were requested to smell material at 2 centimeter distance for 3 seconds, without being able to see the material. Then they would choose an answer in a multiple choice questionnaire. Each nostril was tested separately, therefore the total score for two nostril and 16 materials was 32 for each person. Considering 97 percentile, the normal range of olfactory score for 15-60 years old residents of Rasht was 28-32. This study is helpful to evaluate the patients who complain of hyposmia or anosmia and could be use for future studies