Background: Otitis media with effusion (OME) is one of the main sources of hearing impairment in children. One of the possible causes of middle ear infection and OME is immune system disorders. Based on previous studies, vitamin D deficiency plays an important role in the incidence of middle ear infections. Objectives: This study aimed to determine blood levels of vitamin D in children with OME (as an inflammation of the middle ear) in comparison to a control group of patients admitted to Loghman-Hakim hospital in Tehran. Patients and Methods:In this case-control study, one hundred twenty children with OME who were admitted to Loghman-Hakim hospital between April 2013 and March 2014 and who were candidates for adenotonsillectomy were studied. They were divided into two groups based on tympanometry. The first group contained patients with OME and hearing loss of Type B or Type C2, and the second group (control) contained patients without OME and tympanometry of Type A or Type C2. On the day of surgery, blood samples were obtained for measurement and comparing of serum levels of vitamin D in the two groups. Results: In this study, 120 children (40 cases and 80 controls) that were candidates for tonsillectomy were studied. The largest number of cases was males (60%). The mean age of patients with otitis media was 5.7 ± 2.6 years-old and in the control group was 7.2 ± 2.2 years-old. The mean levels of vitamin D in children with OME was 26.1 ± 14.6 ng/mL and in children in the control group was 29.5 ± 17.9 ng/mL (P = 0.27). Conclusions: Although there was not a significant relation shown between vitamin D levels between the two groups in our study, the vitamin D level in OME patients was less than in the control group. Therefore, it seems that measuring the level of vitamin D in these patients is necessary, and a deficiency of vitamin D must be treated. In order to achieve certain results with more detail we suggest more studies with larger sample sizes and covering a longer time period are needed on this topic.
Background: Frequency, severity, and duration of attacks are some major parameters in headache management, affected by some other factors. Ignoring these factors in headache-related studies can lead to incorrect results. We aimed to model both socio-demographic characteristics and headache-associated symptoms related to frequency, severity and duration of headache attacks. Study design: A longitudinal panel study. Methods: Overall, 275 migraines or tension Type Headache (TTH) patients were visited at three different times in 2012 in Isfahan, Iran. On the first visit socio-demographic characteristics and headache symptoms of the patients were asked. In all of the visits, headache frequency, severity and attack duration were recorded. Results: Frequency of headaches was influenced by headache type, age, job status, working hours, residency, disease duration, laterality, and type of pain onset. In terms of intensity, headaches were more severe in patients with migraine-type; those suffering from longer headache history; and those who suffered from vomiting, photophobia, and phonophobia. On the other hand patients with migraine, married people, women and patients suffering from vomiting experienced longer headache attacks. Conclusion: Headache type (migraine/TTH), age, job status, residency, years of headache, laterality, type of onset, nausea, vomiting, photophobia, and phonophobia were the factors to be considered in the studies that would apply frequency, severity, and duration of headache attacks in order to evaluate headache management.
Objective: Multifocality in gynecologic malignancies is a common phenomenon, however synchronous tumors may occur. Synchronous cancers are about 1.7% of gynecologic malignancies. Methods: A 57-year old female with chief complaint of vaginal bleeding was admitted. Endometrial curettage and cervical biopsy was done.Result: Pathologist reported: compatible with papillary adenocarcinoma, Grade II in endometrial sample and squamous epithelium with moderate dysplasia and tiny fragments of atypical glandular epithelium in endocervical samples. The patient refused for surgical excision of the lesion and insisted on to treat with conventional herbal medicine. Later Pap smear was done and pathologist reported: “High grade squamous intraepithelial lesion (HSIL) and atypical glandular cells, favor neoplastic in atrophic background”. Conclusion: In the case of gynecologic cancer be careful that it may accompany another gynecologic malignancy or premalignant lesion. The second lesion may occur synchronous or metachronous or may be metastatic. Many of the synchronous malignancies are presented in lower stages and have better prognosis than metastatic lesion. Thorough sampling and examination is important in correct diagnosis and treatment.
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