Rhinocerebral mucormycosis in a diabetic patient with cranial nerve involvement

We report a case of 50- year-old diabetic edentulous woman [FBS=396mg/dl] with chief complain of left side facial pain treated by her physician with corticoid and antibiotic for 15 days without any improvement. With pain exacerbation and skin paresthesia she was referred to oral medicine department of Mashhad school of dentistry by a neurologist with diagnosis of dental infection. On examination, she had left side facial palsy, ptosis, and a mass which was anterior to her left ear. Left eye had loss of vision and was fixed. Due to involvement of II, III, IV, V, VI, VII cranial nerves, maxillary sinus, orbit and base of the skull we referred her to neurosurgery department with clinical diagnosis of mucormycosis. Left maxillectomy along with enucleation of left eye was carried out. Histopathology confirmed the diagnosis. Patient was put on amphotericin B under medical care in hospital. Follow up showed the patient is responding and in good health. Early diagnosis and prompt treatment can reduce the mortality and morbidity of this lethal fungal infection

[Demographic and clinical features of ulcerative colitis patients in Kerman city during 2005-2007]

Ulcerative colitis is one of the inflammatory bowel diseases with unknown etiology. Genetic and environmental factors are thought to be effective in this disease. According to the limited studies in our country, general assessment of demographic features and clinical symptoms seems to be essential. In this prospective and cross-sectional study, 85 cases of ulcerative colitis referred to the 3 gastroenterologist offices in Kerman city were evaluated during 2005-2007. The diagnosis was confirmed based on clinical features, colonoscopy, pathology and ruling out of other causes. Data were collected through direct interview and analyzed by SPSS 15 software. Mean age at the time of diagnosis was 33.31 +/- 13.12. Duration of symptoms onset until diagnosis was 8 months. Male to female ratio was 0.8/1 and the most important clinical manifestations were rectorhagia and bloody diarrhea [92.9%], abdominal pain [20%], mucoid diarrhea [13.1%], weight loss [11.2%] and fever [4.4%]. The pattern of disease was chronic intermittent in 83.5%, chronic continuous in 13% and acute self-limited in 3.5%. Anatomically disease was limited to the rectum [8.3%], recto sigmoid [23.5%], recto sigmoid and descending colon [28.5%], transverse colon [21.2%] and pan colitis. [18.8%]. Extra intestinal manifestations were seen in 22.35% of cases of whom 12.96% had oral involvement, 5.85% had hepatic involvement and 3.53% had musculoskeletal involvement. Recurrent inflammatory bowel disease is one of the important reasons of referral to gastroenterologists. Ulcerative coilitis in Kerman is similar to other countries of world epidemiologically, demographically and clinically but its seems that severe clinical courses, extra intestinal manifestations and second old age peak to be less comparing to other studies

Frequency of psychiatric disorders in patients with oral lichen planus referred to oral medicine department of Mashhad dental school

The purpose of this study was to determine the frequency of psychiatric disorders in patients with oral lichen planus. In this descriptive cross sectional study, all the patients with oral lichen planus referred to Oral Medicine Department of Mashhad dental school [from September to October 2003] were examined by a psychiatrist and according to the criteria set by DSM-IV-IR, the presence and type of psychiatric disorders were evaluated. The data were analysed by chi-square and t-tests. Among 56 patients examined, 54 [96/43%] subjects were diagnosed with at least one psychiatric disorder. 96.41% of subjects were categorized as anxiety disorders. In this study, majority of the patients, with oral lichen planus had psychiatric disorders. So psychiatric disorders could have a role in developing oral lichen planus