Otomycosis in central Iran: a clinical and mycological study

Otomycosis is a fungal infection of the external ear with bothersome symptoms. The aim of this study was to evaluate the prevalence of fungal agents, predisposing factors and characteristics of patients. Between May 2008 and April 2010, 171 patients with clinical suspicion of otomycosis were enrolled and the samples from their external ear were examined for any mycological infection. Otomycosis was confirmed after mycological diagnosis in 69% of clinically suspected patients. The highest incidence of otomycosis was in autumn and in patients aged 21-40 years old. Working in dry dusty environment was a major predisposing factor. Pruritus was the most common symptom. Aspergillus flavuswas the most common fungus in otomycosis followed by A. niger, Candida albicans, A. fumigatus, A. nidulansand C. parapsilosis. Clinical suspicion of otomycosis is important to prevent unnecessary use of antibiotics. Etiology of fungal pathogens in dry dusty regions is not similar to hot humid areas and this needs to be considered in future susceptibility tests and treatment of patients with otomycosis

[ study of frequency of nasal obstruction in migraine headaches]

Nasal congestion is a problem in which many person with migraine headache are involved and can induce misdiagnosis in these patients. Many of these patients with nasal congestion believe that the cause of their headache is due to the sinusitis. The purpose of this study was to determine the frequency of nasal congestion in episodes of migraine headache. This was a cross-sectional and descriptive study on 131 patients which were diagnosed by neurologists based on standard criteria to have had migraine. Sampling was done through non-probability in hand method. The data were gathered with regard to age, sex, type of headache and presence of nasal congestion for each patient. They were then analyzed by chi-square and Fisher's exact test [p<0/05]. Out of 131 patients 18 [13.7%] had nasal congestion in their migraine attacks. 19.8% of patients were male and 80.2 patients were female. There was no meaningful correlation between nasal congestion in migraine patients with their sex, age and type of headache. According to the results of the study there was no meaningful correlation between the type of migraine headache [classic and non-classic] and sex and age

[ effects of hydrogen peroxide solution and tetracycline ointment in healing of traumatic facial wounds: a comparative study]

Wound repair after a surgical operation or traumatic injuries is a coordinated process, which is highly dependent to the pre- and post-operative or traumatic care. There is no consensus on the best wound care method and application of topical therapeutic agents including diluted oxygen peroxide solution and antibiotics. This study is aimed to compare the healing effects of oxygen peroxide and tetracycline ointment in management of traumatic facial injuries. 76 patients divided into two groups were entered into this randomized clinical trial. All patients sustained facial injuries requiring primary repair. The first group received 2% topical oxygen peroxide solution for 5 days, and the second group received sterile 1% tetracycline topical ointment for 5days. At the end of the fourth day, wound healing status was assessed with a chart designed for this purpose. No statistically significant difference was observed between the tetracycline and hydrogen peroxide groups in regards to the distance of wound margins, erythema and dehiscence. According to our results, there is no difference in the effects of hydrogen peroxide solution or tetracycline ointment on the healing of traumatic facial wounds

Comparison of actions of botulinum toxin A, between two frontal injections

Beautiful appearance is important for many people particularly with aging. Botulinum A toxin has been used for cosmetic purposes for several years. One of its applications is removal of hyper dynamic facial lines. Its use is very popular due to cheaper and more simplicity, compared to the surgical methods. Also most patients are interested to using it for the second time. Therefore, the aim of this study was to evaluate in the onset and duration of action of this toxin, following the first and the second injection compared to the first injection. This interventional study, was carried out on 61 patients [48 females and 13 males] referred to Al-Zahra and Kashani hospitals of Isfahan for treatment of their facial hyper dynamic lines. At the first visit, 25 units of botulinum were injected at 5 points of the face of the patients and followed up for 6 months. At the end of 6 months, the second injection was administrated to the available patients [25 individuals] using the same dose of toxin and locations. The onset and duration of action in the two periods were recorded. The data was analyzed using t-test. The onsets of clinical actions following the first and the second injections were 3.1 +/- 0.77 and 1.5 +/- 0.41 days, respectively [p<0.001]. Means of the duration of action for the first and the second injection were 14 +/- 2 and 18 +/- 2 weeks, respectively [p>0.05]. The onset of action for the second injection was faster. However, there was no significant difference in duration of action between the two injections

Microbiology and antimicrobial resistance in chronic resistant rhino sinusitis with or without polyp after functional endoscopic sinus surgery

The purpose of this study was microbiology of chronic resistant rhino sinusitis with or without nasal polyp in patients undergoing functional endoscopic sinus surgery and antimicrobial resistance testing. In a cross-sectional study during December 2000 to June 2002, 94 CRS patients with or without nasal polyp were sampled through FESS for microbiology culture and In-vivo antimicrobial resistance was tested in both groups. In CRS group with polyps [42 patients], the most common isolated organisms were Staph. coagulase-negative [26.2%], Staph. areous [23.8%], E-Coli [16.7%], Klebsiella [14.3%] and Enterobacter [7.1%]. In CRS group without polyps [52 patients], the most common isolated organisms were Staph. coagulase-negative [25%], Staph. areous [11.5%], Klebsiella [9.6%], E-Coli [7.7%] and Strep. Non-group A [7.7%]. Normal flora grew in 5 cultures [9.6%]. In only one culture of CRS group without polyp, Pseudomonas was isolated. No resistance was reported from gram-positive bacteria against vancomycin and gram-negative rods were sensitive to ciprofloxacin, ceftriaxon and ceftizoxim. Despite of some previous studies, the most common micro- organisms in the cultures of CRS cases, regardless of having nasal polyps or not, were Staph. coagulase-negative, Staph. aureus and gram-negative rods, respectively. The incidence of GNRs in CRS group with nasal polyps is higher which may lead to special antibiotic therapy in them. Increasing in Vivo resistance of these bacteria to antibiotics is problematic and the routine old antimicrobial therapy may not be effective enough to control these pathogens and avoid surgical therapy. However, In Vivo evaluations are recommended to reveal a better interpretation