Etiology and Epidemiology of Nasal Bone Fractures in Patients Referred to the Otorhinolaryngology Section, 2019

Abstract Introduction One of the most observed diseases in the otorhinolaryngology emergency, compared with the other facial fractures, is related to nasal bone fractures (NBFs). The peak of incidence is seen in the age group ranging from 11 to 30 years old. Objectives The present evaluation was devoted to the etiology and epidemiological study of NBFs. Methods In the present cross-sectional study, 376 patients with NBF were evaluated. The necessary information such as gender, age, education, job, causes of NBF, and clinical symptoms of patients have been recorded on the checklist. Results The study revealed that 76.9% of the patients were male and 23.1% were female; 37.5% of all patients were self-employed, and most of them were from urban areas. Traffic accident (26.6%) and falling (25.5%) were the main reasons for NBF. The most common clinical symptoms for NBF were tenderness (96%; n = 361), nasal swelling (90.4%; n = 340), and deformity (89.4%; n = 336). Conclusions The results showed that the incidence of NBFs in young men without higher education level and self-employed were high which can be related to the traffic accidents and fights. Also, falls, beatings and accidental hit are the most common causes of NBFs among women. Therefore, to decrease the incidence of otorhinolaryngology trauma, training about the general life skill and providing awareness about using personal safety equipment and measures should be increased at the future.

Etiology and Epidemiology of Nasal Bone Fractures in Patients Referred to the Otorhinolaryngology Section, 2019.

Introduction One of the most observed diseases in the otorhinolaryngology emergency, compared with the other facial fractures, is related to nasal bone fractures (NBFs). The peak of incidence is seen in the age group ranging from 11 to 30 years old. Objective The present evaluation was devoted to the etiology and epidemiological study of NBFs. Methods In the present cross-sectional study, 376 patients with NBF were evaluated. The necessary information such as gender, age, education, job, causes of NBF, and clinical symptoms of patients have been recorded on the checklist. Results The study revealed that 76.9% of the patients were male and 23.1% were female; 37.5% of all patients were self-employed, and most of them were from urban areas. Traffic accident (26.6%) and falling (25.5%) were the main reasons for NBF. The most common clinical symptoms for NBF were tenderness (96%; n = 361), nasal swelling (90.4%; n = 340), and deformity (89.4%; n = 336). Conclusion The results showed that the incidence of NBFs in young men without higher education level and self-employed were high which can be related to the traffic accidents and fights. Also, falls, beatings and accidental hit are the most common causes of NBFs among women. Therefore, to decrease the incidence of otorhinolaryngology trauma, training about the general life skill and providing awareness about using personal safety equipment and measures should be increased at the future.

The Relationship between Professional Identity, Performance and Attitude to Medical Errors Self-reporting among Medical Students.

Introduction: Medical errors are a serious problem in providing medical care and ensuring the health of society, and discovering the causes of errors to minimize the possibility of their occurrence is one of the main challenges in the field of treating patients. This study aimed to determine the relationship between professional identity, performance and attitude to self-reported medical errors among medical interns of Ardabil University of Medical Sciences. Methods: This cross-sectional analytical study was conducted on 187 medical interns with census method in five Ardabil educational hospitals in the second semester of 2020-2021. Data collection tool was a questionnaire consisting of 3 parts (demographic, self-reported attitude towards medical errors and professional identity). The validity of the questionnaire was evaluated using Content validity index (CVI) and Content validity ratio (CVR). The reliability of the attitude section was 0.78 and 0.86 for professional identity section. Data analyses were performed using the IBM SPSS Statistics, version 21 by descriptive statistics, such as mean and standard deviation and independent T-test, chi-square and one-way ANOVA. P-values <0.05 were considered statistically significant. Results: The mean scores of students' attitudes towards self-report and professional identity were 55.6±8.8 and 60.4±9.8. Less than 50% of the students declared the possibility of reporting their medical errors. There were no significant differences in the mean scores of self-reported attitude, medical error and professional identity according to grade point average, type of faculty and students' gender (P>0.05). Conclusion: The attitude and performance of students regarding the self-disclosure of medical errors was not satisfactory, and it seems that the analysis of the educational programs in the education of medical errors and the legal and ethical aspects of errors needs serious attention.

Stigma in mothers of deaf children.

INTRODUCTION: A deaf child creates a feeling of stigma in many hearing parents. Stigma in mothers can have a negative impact on a child's treatment and rehabilitation process. Therefore, this study was conducted to evaluate the extent of stigma in mothers with deaf children. MATERIALS AND METHODS: This descriptive, cross-sectional study was conducted in 2013 among 90 mothers with deaf children. The data-collection instrument included the stigma scale in the mothers of children with disabilities. The reliability and validity of the instrument were confirmed through content validity and Cronbach's alpha coefficient (α=86%), respectively. Data were analyzed using SPSS-15 software. RESULTS: Results showed that most mothers suffer from stigma due to having a deaf child. The mean stigma score was 96.48 ±27.72. In total, 24.4% of mothers reported that they had received strange and mocking looks; 72.2% regarded child deafness as a sign of divine retribution; and 33.3% felt ashamed of their child's deafness. There was an inverse relationship between the mother's level of education and mean stigma scores (P<0.033). The stigma score was higher in mothers who were living independently of their relatives (P<0.029). The mean stigma score in mothers of children with a cochlear implant was lower than that of mothers of children with earphones (86.70 vs. 99.64), and this difference tended towards significance (P=0.057). CONCLUSION: This study showed that half of all mothers with deaf children were scorned and felt ashamed of having a deaf child in the family because of the stigma. The majority of mothers with deaf children felt stigmatized, and only their education and residency status affected this issue. The mothers of cochlear-implanted children perceived less stigma. Due to the various social and psychological problems caused by hearing impairment, it is necessary to consider the emotional health and psychological state of the mothers in addition to rehabilitation programs and standard services for the children themselves.

The effect of ketamine on posttonsillectomy pain in children: a clinical trial.

INTRODUCTION: Tonsillectomy is one of the most common surgical operations and has such complications as pain, hemorrhage and laryngospasm. Pain management is of vital importance in order to reduce the suffering and restlessness in children having undergone tonsillectomy. Different studies differ in their findings as to the use of ketamine for postoperative analgesia. The aim of this study was to investigate the effect of peritonsillar injection of ketamine preoperatively on postoperative pain relief. MATERIALS AND METHODS: This was a randomized controlled trial (RCT) on sixty 3-12-year-old children. Children were randomly assigned to the intervention and control groups. Peritonsillar injection consisted of 1 mg/kg ketamine in the intervention group and of normal saline in the control group. An injection of 1 cc was administered on each side five minutes prior to tonsillectomy. Pain assessment was performed using the self-report Oucher Scale and CHEOPS (Children's Hospital of Eastern Ontario Pain Scale) and sedative state assessment was performed using the Wilson Sedation Scale. Pain, medication and complications were studied for 24 hours. Data analysis was performed using chi-squared test and t-test. RESULTS: The ketamine group had a lower pain score compared with the control group (1.40±1.003 compared with 1.53±1.074). The average pain was less in the control group two hours after the surgery. The difference was statistically significant. There was no difference between the two groups in terms of nausea and vomiting incidence. CONCLUSION: The peritonsillar injection of ketamine five minutes prior to the surgery reduces the post-tonsillectomy pain without causing any complications.

Complications related to cochlear implants: experience in Tehran.

OBJECTIVE: Cochlear implantation (CI) is an effective treatment for profound deaf patients. To study the cochlear implant complications in patients at Amir Aalam Hospital. METHODS: The study population involved 177 profoundly deaf patients, implanted within the same cochlear implant center. RESULTS: Twenty-four (13.6%) patients experienced complications. Early complications accrued in 9 (37.7%) patients within the first 24 hours. Eight (4.5%) patients had major complications including facial nerve paralysis, suture rupture and prosthesis rejection. Prosthesis rejection 6 (30%) was the most frequent major complication. Minor complications were found in 16 (9%) cases which were managed medically. Older age with CI was correlated with higher major complications. CONCLUSION: In contrast to minor complications, the frequency of major complications in this cohort was higher than that published by other groups.

Is there any association between Helicobacter Pylori infection and laryngeal carcinoma?

OBJECTIVE: To investigate the possible role of Helicobacter pylori as a cause of squamous cell carcinoma of larynx in a case-control study in an otolaryngology ward at an academic university. SUBJECTS AND METHODS: A total of 65 patients with laryngeal cancer and 65 matched cancer-free controls underwent esophagogastroduodenoscopy and biopsy of antral and body regions of the stomach for evaluation of Helicobacter pylori infection. RESULTS: The proportion of subjects with a positive rapid urease test for gastric infection was similar between the two groups (49.2 % in cases vs. 40% in controls). However, a positive rapid urease test for body was less frequently seen in patients with laryngeal cancer whereas a positive rapid urease test for antrum was significantly higher (P=0.04). CONCLUSION: Our study failed to show Helicobacter pylori as one of the etiologies of laryngeal cancer. However, it supported the hypothesis that colonization of Helicobacter pylori only in the gastric body might have a protective effect against laryngeal cancer with decreasing gastric acid while antral Helicobacter pylori, increasing gastric acid due to G cell hyperplasia, may be a predisposing factor for laryngeal cancer, with acid reflux as a possible underlying etiology.