Viral infections detected by serology and PCR of perilymphatic fluid in children with idiopathic sensorineural hearing loss

The etiology of sensorineural hearing loss [SNHL] in children may be viral. This cross-sectional study aimed to determine the role of viral infectious agents in children with idiopathic SNHL Of 119 children with SNHL aged 3-168 months undergoing cochlear implant surgery at a hospital in Tehran, no cause could be established in 18 cases [15.1%]. Cytomegalovirus [CMV] and herpes simplex virus [HSV] active infections [detected by DNA-PCR, confirmed by serology] were found in the perilymphatic fluid of 16.7% [3/18] cases of idiopathic SNHL Serology was performed on blood samples from 11 of these cases: specific antibodies against CMV, Toxoplasmo spp., HSV and rubella were determined in all cases; acute T. gondii infection was detected in 7 cases and rubella IgG was found in only 1 case. Neonatal screening for CMV, HSV and T. gondii may be helpful in the Islamic Republic of Iran

[Evaluation of hydro-alcoholic extract of peganum harmala on pituitary-thyroid hormones in adult male rats]

Peganum harmala from the Jigo Phalluses family has compounds such as: alkaloid,saponine steroid and lignin which is used as a traditional medicine with antibacterial, anti tumor, inhibition of MAO enzyme, and stimulation of the nerve system. It also serves as a modulator to endocrine activities. The aim of the present study was to evaluate the effect of the hydro-alcoholic extract of Peganum harmala on plasma levels of pituitary-thyroid's hormones of adult rats. In this experimental study, which was conducted at Yasuj University of Medical sciences in 2009, 50 adult Mala rats with the approximate weight of 260+30 grams were divided into 5 groups: the control group, the sham group, and 3 experimental groups. The control group did not take any medicine. The sham group received 1 mL of distilled water daily for 17 consecutive days. The experimental groups took 90 mg/kg, 180mg/kg, or 270 mg/kg of Peganum harmala extract daily respectively for 17 consecutive days. In the 18th day, by collecting the blood samples of the animals, plasma level of TSH, T4, and T3 was measured using radioimmunoassay method. Collected data were analyzed using SPSS software. This study revealed that the minimum and maximum dose of the Peganum harmala extract reduces the TSH level and average and maximum dose of the extract significantly reduces the level of T4 and T3 in rats. results of this study indicate that by further study the Peganum harmala extract might be used for treatment hyperthyroidism. However further study is needed to explore this concept

[Screening of DFNB4 locus in Iranian families with hereditary hearing impairment]

Mutations in the SLC26A4 gene in the DFNB4 locus is responsible for syndromic [Pendred syndrome] and non-syndromic hereditary hearing loss [HHL]. In many populations, mutations in this gene have been reported as a second cause of HHL. The objective of this study was to investigate the prevalence of SLC26A4 mutations in our HHL consanguineous families. After completing clinical evaluation and obtaining signed consent forms from each family, we included 80 families with two or more affected individuals, referred to the Genetics Research Center [GRC]. All families that previously tested negative for the DFNB1 locus were candidates for homozygosity mapping using STRs for DFNB4 locus. Families localized to this region were subjected to complete DMA sequencing. Twelve out of 80 families were mapped to DFNB4. Sequence analysis of 12 linked families revealed 10 mutations in 8 families. [T420I, 1197delT, G334V, R409H, T721M, R79X, S448L, L597S, 965insA, and L445W]. The T420I, G334V, L597S and R79X were novel mutations; we did not find any mutation in the four linked families, nor did we detect any nonsyndromic families with mutation in the SLC26A4 gene. We have been able to identify mutation in the SLC26A4 gene in only 8 of 80 families. In 12 families, we detected some degree of diffuse or nodular goiter; three out of 12 families showed thyroid function impairment and in five of 12 families there were positive prechlorate discharge tests. Eight families that showed mutation had normal temporal bone scan. This investigation, demonstrated that the SLC26A4 gene mutation is the most prevalent syndromic hereditary hearing loss in Iran, a finding in accordance with reports from other countries

Drill-and suction generated noise levels in mastoid surgery

It has been recognized that noise levels generated during ear surgery may cause sensorineural hearing loss. However, there is a controversy about the main factor that may cause such hearing threshold alternations: drilling, suction or both of them. The purpose of this investigation was to measure the air-conduction noise levels generated by common drills, burrs and suction irrigators in mastoid surgery. Our evaluations were carried out in two states: isolated temporal bones [cadavers] and intraoperative recordings. Preliminary drillings were made on 10 cadavers, and intensity and frequency analysis of common diamond and cutting burrs were performed. Then, the noise levels generated by drilling, suction irrigation and simultaneous drilling and suction irrigation were measured from 15 patients under radical modified mastoidectomy. Data were analyzed by SPSS II software and 0.05 value was regard as significant level. The average noise levels of drilling ranged from 83 to 95 dB SPL, varying with burr used. Cutting burrs were found to be up to more intense than diamond burrs. Mean suction irrigation noise levels ranged from 77.45 to 78.65 dB SPL. The average of "intraoperative drilling" and "simultaneous drilling and suction irrigation" generated noise levels were 87.14 and 86.26 dB SPL, respectively. The comparison of resultant noise levels between cadaver and under operation situations was not statistically significant. Our results showed that the main factor contributing the highest noise level is drilling which is predominately apparent in cutting burrs. Exposure to these noise levels may account for shifts in the hearing thresholds

[Actinomycotic scalp pseudotumor]

Introduction and Objective: actinomycosis is an indulent, slowly progressive infection caused by anaerobic or microaerophilic bacteria that normally colonize the mouth,colon and vagina.The most common location for diagnosed actinomycosis is the perimandibular region . Oral cervicofacial disease can be manifested as a mass lesion. Actinomycosis should be considered in the differential diagnosis of any mass lesion in the head and neck region. Bacteriologic identification from a sterile site or detection of sulfur granules accompanied by microorganism confirms the diagnosis

Case: this patient is a 11 old years boy that presented with nearly painless mass on right temporal area of the scalp and trismus that developed from ten days ago. Skull and brain CT scan showed a subcutaneous swelling without bone and brain extension. Blood indexes were normal except ESR that was 55mm in first hour. Pathology of complete mass excision showed actinomycosis and after high dose penicillin therapy parenteral route normalized ESR and the patient had not any problem in follow up

Conclusion : atinomycosis can manifest as a progressive painless mass of the scalp that easily diagnosed as a neoplasm

Cochlear implantation in Iran

Cochlear implantation has become an increasingly common procedure in the, rehabilitation of selected cases of profound deafness. Patients should have profound total bilateral sensorineural hearing loss. Sound is transformed into small electric currents which stimulate the auditory nerves in the cochlea and generate the hearing sensation. The nucleus cochlear implant is the result of more than 20 years of research and development and has been used in more than 9000 patients worldwide to date. After two years of research in order to provide the cochlear implant in the Farsi [Persian] language, three out of 54 post lingual totally deaf patients up to now have undergone the cochlear implant operation with a 22-channel mini-system through a Lehnhardt incision, mastoidectomy, facial recess, and cochleostomy procedure. One month following the implant, these patients were undergoing speech education and auditory training by using innovative rehabilitation techniques for deaf people in the Persian language. This report deals with presenting three cases implanted by a cochlear implantation team in Iran and the results of rehabilitation following implant