Hearing Status in Patients with Type 2 Diabetes Mellitus According to Blood-Sugar Control: A Comparative Study.

INTRODUCTION: It seems that diabetes mellitus (DM) can affect the auditory system due to neuropathy, micro-vascular complications, and hearing cell damage during hyperglycemic states. In the current study, we aimed to compare hearing status in patients with type 2 DM (T2DM) according to their blood-sugar control status. MATERIALS AND METHODS: This cross-sectional study was carried out in 104 patients with T2DM attending the diabetic clinics of Guilan University of Medical Sciences within a period of 1 year (2014-2015). One group consisted of 52 patients with poor control and the other consisted of patients with moderate-to-good control (according to glycated hemoglobin [HbA1c] level). All subjects underwent pure tone audiometry (PTA) and distortion product otoacoustic emission (DPOAEs) assessments. A hearing threshold higher than 20 dB and a signal-to-noise ratio ≤3 in each frequency were considered abnormal. RESULTS: In PTA, poorly controlled patients showed more frequent hearing loss compared with the well-controlled group, especially at higher frequencies (8 kHz: 67.3% vs 46.2% [P=0.029]; 10 kHz: 46.2% vs 21.2% [P=0.025]). Also, patients in the poorly controlled group had worse cochlear function according to the DPOAE test (4 kHz: 32.7% vs 17.3% [P= 0.002] and 8 kHz: 70.6% vs 40.4% [P=0.006]). CONCLUSION: DM and poor control status of diabetes can affect hearing sensation and cause hearing loss, especially at high frequencies. According to our findings, it seems that diabetic patients with a duration of diabetes >10 years, diabetic complications, poor control status or comorbidities should undergo both endocrine and audiologic follow-up to prevent greater sensory neural hearing loss.

Can laser treatment improve quality of life of hirsute women?

BACKGROUND: Hirsutism can have negative impacts on psychosocial aspects of women's lives and reduce their quality of life (QOL). The aim of this study was to assess the QOL of these women during laser treatment. PATIENTS AND METHODS: Eighty-eight women with unwanted facial hair underwent laser therapy. Each patient completed a questionnaire consisting of a modified Dermatology Life Quality Index (DLQI) and visual analog scale (VAS) before the first, third, and fifth sessions of laser therapy. Interval between the sessions was 4-6 weeks. Statistical analyses were done using SPSS software version18. RESULTS: The DLQI scores before treatment, and at third and fifth sessions were 7.75±2.36, 5.55±1.88, and 4.14±0.64, respectively (P<0.0001). Also, VAS scores had a decreasing trend between the first and second treatment sessions as the mean patient VAS score fell from 10±0.04 to 5.53±2.41 (P<0.0001). The DLQI scores were significantly different according to areas of hair growth and number of involved areas. There were no significant differences with regard to response to treatment and mean of DLQI score according to the level of education, marital status, and employment status. CONCLUSION: Hair removal with laser therapy can improve the QOL in hirsute women. Also, socioeconomic status does not affect the satisfaction rate of laser therapy for hair removal.

Giant Right Coronary Artery Aneurysm Mimicking a Mediastinal Cyst With Compression Effects: A Case Report.

INTRODUCTION: Giant coronary artery aneurysm is an extremely rare form of coronary artery disease. The most common cause of coronary artery aneurysms is atherosclerosis. Although it is usually asymptomatic, it may have various clinical presentations, including angina, myocardial infarction or sudden death. CASE PRESENTATION: A 32-year-old woman presented with edema of the upper and lower limbs, palpitation, and chest pain, and was diagnosed with a giant right coronary artery aneurysm that had initially mimicked a mediastinal cyst. Although computed tomography (CT) suggested a mediastinal cyst, trans-thoracic echocardiography revealed an extra pericardial cyst. The definitive diagnosis of right coronary artery aneurysm was made based on CT angiography and coronary angiography findings. As treatment, aneurysmectomy was performed, and she was discharged on the sixth postoperative day with good general health condition. CONCLUSIONS: Coronary artery aneurysm should be a differential diagnosis in cases of mediastinal cyst and mass lesion.

Granulomatous mastitis: Presentations, diagnosis, treatment and outcome in 206 patients from the north of Iran.

OBJECTIVES: The aim of this study is to review the clinical presentations, diagnostic methods, treatment options and outcome of patients with Granulomatous Mastitis (GM). MATERIAL AND METHODS: In a retrospective study, we indentified 206 women who met the required histological criteria of (GM). RESULTS: Thirty eight (18%) of these women had taken antibiotics before their diagnosis of GM. The most common symptoms in remaining 168 symptomatic women were breast mass. The most common ultrasonographic and mammographic finding was large irregular hypo echoic masses and an irregular mass, respectively. As a diagnostic tool, fine needle aspiration (FNA) was performed in 33 (19.5%) and core needle biopsy with or without ultrasound was done in 92 (55%) of patients while successful rate was 13 (39%) and 87 (94.5%), respectively. The remaining 43 (25.5%) of women underwent surgical excisions. Only 6 (3%) patients improved with antibiotics and 200 (97%) of women who did not respond to antibiotics, were treated with steroid and among them 144 (72%) improved. Treatment with combination of methotrexate and steroid was done in 56 (28%) patients and was effective in 40 (71%) of them. Sixteen (8%) patients were treated with a combination of steroid and bromocriptine which was effective in 5 (31%) patients. A wide surgical excision was performed in 11 (5.5%) patients who were nonresponsive to steroid and methotrexate and bromocriptine therapy. CONCLUSION: Our findings indicate that clinical and imaging findings of (GM) have overlapped with malignancy. The best diagnostic method is core needle biopsy. Corticosteroids are in the first line of treatment with a good therapeutic response.

Effect of obesity on arthroscopic treatment of anterolateral impingement syndrome of the ankle.

The present case series study was performed to evaluate the effect of obesity on the arthroscopic findings and the functional outcome after arthroscopic treatment of anterolateral impingement syndrome of the ankle. The study was conducted on 36 patients (26 were classified as obese [body mass index ≥30 kg/m(2)] and 10 as not obese [body mass index <25 kg/m(2)]) who had previously undergone arthroscopic treatment of anterolateral impingement syndrome of the ankle. The arthroscopic findings and demographic features were recorded. The patients were examined postoperatively at 6 and 12 months postoperatively, and AOFAS scores were obtained. Our data showed that obese patients had the same arthroscopic findings as nonobese patients, except for chondral lesions. At 1 year of follow-up after performing arthroscopy, the presence of obesity had no effect on the functional outcome of arthroscopic treatment of anterolateral impingement syndrome of the ankle.Obesity has no effect on the effectiveness of arthroscopic treatment.

Posterior mediastinal cyst.

Hydatid disease is still an important health problem in the world. Mediastinal localization of hydatidosis is very rare. We report the case of a 19-year-old man who presented with right chest wall pain and cough. Chest X-Ray and computed tomography showed a mediastinal cystic mass. A right posterolateral thoracotomy was performed and the cystic mass was identified. Daughter cysts were seen within the cyst when the lesion was accidentally opened during the procedure. Cyst mass was radically resected. No complication or recurrence was seen in the follow-up period.

Otomycosis in the north of Iran: common pathogens and resistance to antifungal agents.

Otomycosis as a kind of external otitis can be caused by various species of fungi. To use the appropriate treatment, it is necessary to identify the causal agent of otomycosis. The aim of this study was to determine the pathogens that caused otomycosis and also the efficacy of different antifungal agents. 100 patients with diagnosis of otomycosis/otitis extern were entered in this study. Bacterial culture was performed by eosin methylene blue agar, blood agar; and Sabouraud dextrose agar was used to culture the fungal agents. Minimum inhibitory concentration test also was performed to determine the efficacy of Clotrimazole, Fluconazole, Ketoconazole and Nystatin on the fungal pathogens. Otomycosis was confirmed in 43% of patients by positive culture. The most prevalent fungal pathogen was Aspergillus niger which was sensitive to Clotrimazole, Fluconazole, Ketoconazole. Candida albicans was sensitive to all drugs, in which, the most sensitivity was due to fluconazole. The most frequent fungal pathogen in our otomycosis cases is A. niger, and most of fungi that caused otomycosis are sensitive to clotrimazole.

Arthroscopic treatment of patients with anterolateral impingement of the ankle with and without chondral lesions.

Anterolateral impingement syndrome is defined as chronic pain in the ankle secondary to soft tissue impingement, hypertrophy, or tearing of the lateral and anterolateral ligaments of the ankle. The purpose of the present study was to evaluate the results of arthroscopic treatment of anterolateral impingement syndrome and its association with chondral lesions. In this case series study, 23 patients with anterolateral impingement syndrome underwent arthroscopic debridement of the ankle. Simple radiography and magnetic resonance imaging were applied for all the patients to diagnose the spur condition and to exclude patients with other possible lesions. All the patients were evaluated preoperatively and at interval visits of 2, 4, and 6 weeks and 3 and 6 months postoperatively according to the American Orthopaedic Foot and Ankle Society criteria and Meislin score. The mean patient age was 38.13 ± 6.85 years. Significant differences were seen between the mean American Orthopaedic Foot and Ankle Society scores, which was 59.21 before surgery and 83.56 and 88.13 at 3 and 6 months postoperatively, respectively. No significant differences were seen between the American Orthopaedic Foot and Ankle Society scores of the patients with or without chondral lesions. Arthroscopic treatment of anterolateral impingement syndrome is recommended as the treatment of choice and is still considerably effective in patients with chondral lesions.