Journal Of Research In Medical Sciences (17357136)10(1)pp. 10-15
Background: Lateral osteotomy is a major part of rhinoplasty for remodeling external facet of the nose and narrowing of nasal base and dorsum after removal of the hump. There are two techniques for lateral osteotomy known as external and internal. Each of these provide advantages and impose limitations. The purpose of our study was to compare the severity of postoperative edema and ecchymosis between internal and external osteotomy techniques. Methods: This study was designed as a clinical trial on 30 cases. With randomization, one side of the nasal bone was selected for internal approach, and the other side, for external approach. Then, on the 1st and 7th days after surgery, the patients were scored for the severity of edema and ecchymosis. Results: On the first day after surgery, not only edema, but also ecchymosis was lower with the external osteotomy than with the internal approach (P = 0.037, P = 0.002, respectively). The severity of ecchymosis, on the 7th postoperative day, was lower with the external approach, and the difference was significant (P = 0.011). The severity of both edema and ecchymosis on the first postoperative day was evaluated higher in females, with statistically significant differences (P = 0.05 for edema and P = 0.003 for ecchymosis). The extension of ecchymosis on the 7th postoperative day was higher in women (P = 0.05). There were no significant differences between the two approaches in medialization of the involved bones and no apparent asymmetries either. Conclusion: According to the results of this study, external osteotomy seems to be the approach of choice, provided that the surgeon has enough experience in doing it.
Journal Of Research In Medical Sciences (17357136)10(3)pp. 167-171
Background: 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. Patients and methods: 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. Results: 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. Conclusion: 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.
Journal Of Research In Medical Sciences (17357136)10(1)pp. 25-30
Introduction: The antihypertensive drug, clonidine, is a centrally acting alpha 2 agonist, useful as a premedication because of its sedative and analgesic properties. We examined the effect of clonidine given as an oral premedication in producing a bloodless surgical field in patients undergoing endoscopic sinus surgery. We also evaluated the relation between bleeding volume and consumption of fentanyl and hydralazine to control hypotension. Methods: This prospective double - blinded clinical trial was performed on 113 patients (ASA I, ASA II). Fifty-two patients received oral clonidine (5, μ g/kg) while the other 61 patients received placebo. During general anesthesia, the hemodynamic endpoint of the anesthetic management was maintenance of hypotension (MAP) at 70 mmHg for producing a bloodless surgical field. The direct control of MAP was attained with inspired concentration increments of halothane up to maximum of 1.5 vol % as needed. When it was unsuccessful, an intravenous fentanyl bolus of 2, μ g/kg was also added. When both drugs failed, hydralazine, was given intravenously as a bolus and intermittently, 0.1mg/kg up to a maximum dose of 40 mg. Intraoperative bleeding was assessed on a six - point scale from 0 (= no bleeding) to 5 (= severe bleeding). Data were compared with chisquare test, fisher's exact test and Student t-test. Results: There was less bleeding volume in the clonidine group (mean ± SD) than in the placebo group (144 ± 75 Vs 225 ± 72 ml, P<0.05). Frequency of bleeding severity scores 3 and 4 (troublesome with repeated suction) were lower in the clonidine group than in the placebo group (12% Vs 35%, P< 0.05). Fentanyl requirement was significantly lower (112 ± 18 Vs 142 ± 21 μ g, P < 0.05) in the clonidine group. Hydralazine requirement was significantly lower (0.45 ± 1.68 Vs 2.67 ± 4.33 mg, P<0.05) as well. Conclusion: Premedication with oral clonidine reduces bleeding in endoscopic sinus surgery and also decreases fentanyl, and hydralazine consumption for controlling hypotension.
Journal Of Research In Medical Sciences (17357136)10(6)pp. 381-383
Background: One of the most common techniques of nasal tip surgery in rhinoplasty is conservative resection of cephalic portion of nasal alar cartilage; although, there is a controversy about its effectiveness on nasal tip rotation in textbooks and articles. Therefore, in this research, we have studied the effect of conservative resection of cephalic portion of alar cartilage on nasal tip rotation. Methods: 35 patients were selected from the patients who were candidates for septoplasty, after getting their agreement. In surgery we performed conservative resection of cephalic portion of alar cartilage. Nasolabial angles were calculated, using the lateral photographs of the patients before and six monthes after surgery. The means of these angles were analyzed with t-paired test. Results: The means and standard deviations of nasolabial angles before and six months after surgery were 91.49±7.35 and 91.57±7.04, respectively. Calculated P-value was 0.52. Conclusion: There was no meaningful difference between means of nasolabial angles before and six months after surgery (P-value was greater than 0.05). Therefore, in this research we concluded that conservative resection of cephalic portion of alar cartilage has no effect on nasal tip rotation.
Journal of the Royal Asiatic Society (14740591)15(3)pp. 261-277
Amiridavan, M.,
Nemati, S.,
Hashemi, S.M.,
Jamshidi m., M.,
Saberi, A.,
Asadi, M. Journal Of Research In Medical Sciences (17357136)11(4)pp. 263-269
Background: Sudden sensorineural hearing loss (SSNHL) is a perplexing condition for patients and there are many controversies about its etiology, audiologic characteristics, prognostic factors, and treatment. Methods: In this prospective study, we performed some audiologic tests, including PTA, IA, ABR, and OAE (TEOAE) before beginning treatment of 53 patients with SSNHL. We assigned the patients randomly to two treatment groups: oral steroids + acyclovir vs. intravenous urographin. Twenty-eight patients underwent Magnetic Resonance Imaging (MRI) of the Brain. Results: Of 53 patients (22 female and 31 male), 22 (41.5%) had negative or no signal to noise ratio and overall correlation in TEOAE. Twenty-six patients (49%) had positive overall correlations less than 50%, and 5 patients (4.4%) had overall correlations >50%. Fifteen patients (28.3%) responded completely or well, 20 (37.7%) responded partially, and 18 (33.9%) had poor or no response to the treatment. The mean values for overall correlation in 3 subgroups of patients (no response, partial response, and complete response) were - 3.5% (± 1/16%), +11% (± 1/ 99%), and +36.6% (± 3/07%), respectively (P = 0.01). Twenty out of 52 patients had no reproducible wave in ABR (38.5%), and waves I, III, and V were absent in 40 (77%), 31 (59.6%) and 21 (40%) patients, respectively. There were some limitations (false positive and false negative results) in ABR use in our cases, but it may be useful in detecting site of lesion in SSNHL. Overall, according to the results of OAE, ABR, and brain MRI of these patients, 3 were affected by acoustic neurinomas, at least 1 had auditory neuropathy, and the site of lesion was cochlear in 6, and cochlear + retrocochlear in 13 patients. Conclusions: ABR has limitations for use in SSNHL and seems not to obviate the need for brain MRI, but may help in determining the site of lesions such as ischemia or neuropathy. Overall correlation (and S/N ratio) in TEOAE is a valuable prognostic factor in SSNHL, hence we recommend performing TEOAE in every patient with SSNHL.
Journal of the Royal Asiatic Society (14740591)16(1)pp. 29-41
Journal of the Royal Asiatic Society (14740591)16(2)pp. 151-163
Salek, M.,
Hashemipour, M.,
Hashemi, S.M.,
Hajrahimi, M.,
Sadeghi, S.,
Farajzadegan, Z.,
Hovsepian, S.,
Hadian, R. Journal of Isfahan Medical School (10277595)25(87)pp. 53-59
Background: Congenital hypothyroidism (CH) has a considerably high prevalence in our country, and without early treatment, it would lead to irreversible sequelae like hearing impairment. This study was aimed to investigate the prevalence of hearing loss in children with CH in comparison with healthy children. Methods: This case-control study was conducted in two groups of children; the case group consisted of 94 children with CH aged more than 4 months under follow up in Isfahan endocrine research center; the control group included 450 healthy infants underwent routine neonatal hearing screening in a private hospital. First, Otto Acoustic Emission (OAE) test was performed, and in the case of being abnormal, then auditory brain stem response (ABR) test was conducted. Children with abnormal ABR were considered to have hearing impairment. Findings: The prevalence of hearing impairment was not significantly different between children with CH and controls (3.2% vs. 0.2%, respectively; p>0.05). The mean age of beginning the treatment for CH was not significantly different between children with or without hearing impairment (13.6±8.3 vs. 16.4±8.05 days, respectively; p>0.05).The mean T4 and TSH was not significantly different between children with CH with and without hearing impairment (5.6±4.2 mg/dl and 133.7±80.3 MIU/l vs. 6.2±3.7 mg/dl and 116.5±92.1 MIU/l, respectively; p>0.05). Conclusion: We did not document any difference in the prevalence of hearing impairment in children with CH and controls; this finding might be because of limited number of subjects studied and the short duration of follow up. There was no difference neither between the age of beginning the treatment for CH and hearing impairment, nor between the mean T4 and TSH at birth and hearing impairment. Hearing loss has no relationship with age at treatment onset and primary T4 and TSH level at diagnoses. © 2007, Isfahan University of Medical Sciences(IUMS). All rights reserved.
Berjis, N.,
Nakhaee, A.,
Narimani, A.A.,
Shahraki, Z.D.,
Hashemi, S.M. Journal of Isfahan Medical School (10277595)25(87)pp. 97-101
Background: This retrospective study was conducted to determine the prevalence of nasopharyngeal angiofibroma according to age, stage, clinical signs and average blood transfusion during surgery in educational hospitals affiliated to Isfahan University of Medical Sciences. Methods: This retrospective study was conducted on 250 records of patients suffering from angiofibroma and hospitalized from 1988 to 2003 in Al-zahra and Ayatollah Kashani hospitals, affiliated to Isfahan University of Medical Sciences. Findings: All cases were male, and the mean age was 16 years with a range of 7 to 41; the highest prevalence was found in the 11-20-year-age group. The most frequent sign was epistaxis (80%) and nasal obstruction (70%). The average volume of blood transfusion during the surgery was 4-5 units. The most frequent stage at the time of diagnosis was IIB and IIC (complete invasion of petrygomandibular fossa and protrusion to infratemporal fossa) and the rarest stage was IA and IIA according to Session classification. Conclusion: Angiofibroma is a rare tumor; however it is the most frequent nasopharyngeal tumor in young adults. Although it has benign histology, but can have important side effects. Its early diagnosis and treatment can prevent its side effects and may facilitate the surgery; hence it should be considered in the differential diagnosis of nasopharyngeal disorders. © 2007, Isfahan University of Medical Sciences(IUMS). All rights reserved.
Carbon nanotubes are widely used in the design of nanosensors and actuators. Any defect in the manufactured nanotube plays an important role in the natural frequencies of these structures. In this paper, the effect of vacancy defects on the vibration of carbon nanotubes is investigated by using an atomistic modeling technique, called the molecular structural mechanics method. Vibration analysis is performed for armchair and zigzag nanotubes with cantilever boundary condition. The shift of the principal frequency of the nanotube with vacancy defect at different locations on the length is plotted. The results indicate that the frequency of the defective nanotube can be larger or smaller or equal to the frequency of perfect one. The results also show that with the reduction in the tube length, the variations of principal frequency are enhanced. However, the frequency variation is insensitive to the nanotube diameter. As the number of vacancy defects increases, shift in the natural frequency also increases as expected. © 2008 IEEE.
Sonbolestan s.m., ,
Barzegar f., ,
Jamshidi m., M.,
Hashemi, S.M.,
Honarmand a., Tehran University Medical Journal (17357322)66(6)pp. 402-407
Background: Post-tonsillectomy pain is often severe and usually prevents patients from routine eating and drinking. A new option for reducing postoperative pain is "preemptive analgesia", the pre-, intra-or post-operative administration of analgesic agents. Ketamine, an N-methyl D-aspartate receptor antagonist, has recently received attention for this aim. Herein, we study the effect of submucosal injection of ketamine in the tonsillar bed for the reduction of post-tonsillectomy pain. Methods: In this double-blind clinical trial, three groups of patients underwent infiltration of 0.5mg/kg ketamine, 1mg/kg ketamine or normal saline in their tonsillar bed. Age, sex and weight of patients, duration of surgery, systolic and diastolic blood pressure (before and after surgery), volume of blood loss, reoccurrence of bleeding, time to initiation of oral intake, nausea, vomiting, pain score and dysphasia were recorded in information sheet. Data analysis was performed by one-way ANOVA and chi squared tests, with significance at a P value of <0.5. Results: There is no significant difference between the three groups with regard to age, sex, weight, duration of surgery, blood pressure (before surgery), volume of blood loss, nausea and vomiting. However, for the ketamine groups, pain score, dysphasia, need for opioid administration and time to initiation of oral intake is significantly lower (P<0.00). Reoccurrence of bleeding was observed in one patient in the lower-dose ketamine group, which is not statistically significant. The effectiveness of the two doses of ketamine is similar, with no statistical difference between the two groups (P=0.84). Conclusions: This study demonstrated that a submucosal injection of ketamine into the tonsillar bed preoperatively is a safe option for reducing post-tonsillectomy pain, dysphasia, need for opioid and time to initiation of oral intake, without increasing the risk of excessive bleeding, reoccurrence of bleeding, nausea and vomiting. © 2008, Tehran University of Medical Sciences. All rights reserved.
Hashemi, S.M.,
Rogha, M.,
Miralahi, S.,
Nakhaei, A.,
Khodami, A.R. Journal of Isfahan Medical School (10277595)27(98)
Background: Intratympanic steroid injection is an effective method in treatment of sudden sensorineural hearing loss in cases resisted to systemic therapy. The purpose of this study was to determine the efficacy of intratympanic injection. Methods: This case-series study was carried out on fifteen patients with sudden sensorineural hearing loss that had failed systemic therapy. Audiometric evaluation (PTA) performed before and after treatment and intratympanic dexametasone injection performed and the amount of improvement evaluated. Data Analysis was done using SPSS11. Findings: In male patients, 33.3% partial and 33.3% complete improvement and in female patients, 18.6% partial and 50% complete improvement was reported. In cases with lower degrees of hearing loss, total improvement was 66.7%; also earlier time of treatment had better results. Conclusion: Intratympanic injection of steroid is one effective modality in treatment of sudden sensorineural hearing loss in cases with no response to standard systemic therapy. It can improve the hearing level of patients while its complication rate is low and as degree of hearing loss increases the results decrease earlier treatment have a better results. © 2009, Isfahan University of Medical Sciences(IUMS). All rights reserved.
Okhovvat, A.R.,
Karim, M.,
Hashemi, S.M.,
Hashemi, S.M.,
Berjis, N.,
Amiridavan, M. Journal of Isfahan Medical School (10277595)27(103)
Background: We report the diagnosis, treatment and follow–up process of 22 cases of fungal sinusitis. Methods: This case- series study was carried out on 22 patients with fungal sinusitis that had treatment of endoscopy and antifungal drug. Past medical history, pathology, CT scan findings and treatment of patients were evaluated. Data analysis was done using SPSS. Findings: Twelve male (57%) and 10 female (43%) patients with the age of 16-73 years were a ssessed. Mucormycosis was seen in 18 (82%) and Aspergilosis in 4 (18%) patients. Diabetic mellitus (71%), chronic renal failure (CRF) (14.3%), and leukemia (9.6%) were reported as the most common underlying diseases. Maxillary and etmoid sinuses were the site of involvement. The most common sign was unilateral periorbital edema and proptosis (95%), and the most common symptom was unilateral change of visual acuity and cheek sensation (95%). All the patients had endoscopy surgery and treated with amphotricine B or ithraconazole and ceftrinaxone, metronidazole and vancomycine. Death was reported in 5 patients (22%) and renewed functional endoscopic sinus surgery (FESS) in 1 (4.8%). Conclusion: Functional endoscopic sinus surgery with amphotncine B or ithraconazole and follow-up are effective for fungal sinusitis. © 2010, Isfahan University of Medical Sciences(IUMS). All rights reserved.
Moafi, A.,
Rahgozar, S.,
Ghias, M.,
Ahar, E.V.,
Borumand, A.,
Sabbaghi, A.,
Sameti, A.,
Hashemi, S.M. International Journal Of Preventive Medicine (20088213)2(4)pp. 280-285
Objectives: Obesity and increased blood pressure are identified as risk factors for cardiac and pulmonary disorders. On the other hand, iron deficiency (another preventable disease) is common in adolescence and considered as associated with health impairment. The present study evaluates body mass index (BMI) and its association with blood pressure and hematological indices in freshman students entering the University of Isfahan in 2009. Methods: All the 1675 students who entered the University of Isfahan in September 2009 were examined. Height, weight, BMI, blood pressure, hemoglobin (Hb) and red blood cell (RBC) indices of these students were measured. The prevalence of high blood pressure, its association with BMI and the relation between BMI and anemia, iron deficiency and educational achievement were assessed. Results: All participants, including 514 males and 1161 females, went under clinical observations. The average age was 20.7 ± 3.8. year Among the students, 18.2% of males and 20% of females were underweight. High systolic blood pressure was more common in the students with BMI > 25 kg/m2 (p < 0.001). Anemia was seen in 8.7% of females. In males, however, a relation between anemia frequency and BMI < 18.5 kg/m2 was more distinct (p = 0.002). There was no association between anemia and students' average test scores. Conclusions: High incidence of abnormal BMI in the study population, and its association with systolic blood pressure indicate the importance of nutritional guidelines and counseling programs for freshman students. On the other hand, high incidence of anemia in this population ascertains the necessity of anemia screening programs before academic studies.
Journal Of Research In Medical Sciences (17357136)16(1)pp. 74-78
BACKGROUND: Recurrence of nasal polyposis following surgical intervention is very common. Antifungal therapy has been an appealing alternative to reduce its recurrence and severity. Early studies showed definite positive response, but recent studies have raised doubts about its efficacy in treatment of polyposis. METHODS: This prospective case-control clinical trial was conducted on 50 patients suffering from nasal polyposis in Isfahan university of medical sciences. All patients underwent functional endoscopic sinus surgery. CT scanning of paranasal sinuses was done preoperatively and 6 months postoperatively to stage the disease. Patients were assigned to two groups: amphotericine B group were instructed to irrigate the nasal cavity with a solution of amphotericine B, while the normal saline group used the physiologic normal saline for 6 months. RESULTS: 68% of patients in Normal saline and 84% of cases in amphotericine B group reported history of allergies. In amphotericine B group, stage of the disease improved in 84% of patients and remained unchanged in the rest. In normal saline group, imaging stage improved in 22 patients and remained unchanged in 3. The two cohorts were compared for reduction in imaging stage and no significant difference was found between them. CONCLUSIONS: This study showed no benefits for topical amphotericin B solution over normal saline. It might be better to retreat to the traditional normal saline nasal douching following functional endoscopic sinus surgery in the treatment of polyposis.
Barati, B.,
Omrani, M.R.,
Okhovat, A.,
Kelishadi, R.,
Hashemi, S.M.,
Hassanzadeh, A.,
Abtah, M.,
Omidifar, N.,
Okhovat, H. Journal Of Research In Medical Sciences (17357136)16(4)pp. 509-515
Background: Antimicrobials treatment of Otitis media (OM) reduces some complications, but some of chronic complications, and specially otitis media with effusion (OME), seem to increase. Theoretically the usage of nasal corticosteroid sprays may prevent this problem by reducing the local inflammation around the eustachian tube. So, this study aimed to evaluate the role of nasal corticosteroid spray as an adjuvant for the treatment of OME. Methods: In a randomized, prospective clinical trial, 2 groups of 46 subjects who had OME were recruited. A questionnaire containing patients' characters, history, complaints, otologic examinations, and the report of tympanometries was filled for all before and after treatment. We administered a period of amoxicillin and a decongestant for both group and nasal beclomethasone spray only for case group. Results: Thirty five of cases (76.1%) and 22 (47.8%) of controls had an improvement in their symptoms or the quality of hearing (p = 0.005). Partial remission was the most common finding in 52.2% of the patients in the case group but for control group there was no change (p = 0.024). The higher improvement in the tympanic retraction in the case group was significant (p < 0.05). A significant better tympanometric result has showed in the treatment of left ear in the patients of the case group (p = 0.038) but not for right ear (p = 0.136). Conclusions: We concluded that the administration of nasal beclomethasone spray as an adjuvant for the treatment of OME not only improved the results treatment but also increased the resolution of symptoms and the patients' quality of hearing.
Journal of the Royal Asiatic Society (14740591)21(2)pp. 131-145
The issue of the purchase of land in one country, in this case Iran, by other countries, in this case Britain and Russia, is one of great significance because of light it may throw on the strength or weakness of national sovereignty, and the ways and degree to which it may be undermined.1 It can also show the strategies deployed by the country challenged to protect its territorial integrity, as here in the case of Iran. The intricacies of foreign landownership patterns thus have implications for international relations, on which they can provide telling detail in terms of contemporary power politics. The details of land purchase also demonstrate considerable differences as between the two outside powers involved in terms of their objectives in Iran, and thus challenge a tendency in the literature to see them as similar. At the same time, from this particular study, Qajar Iran, which is so often represented as weak, näýve and ineffectual in the face of the challenge of great power intervention, emerges as having dealt skilfully with this particular form of intrusion with a variety of stratagems that were not without success for much of the nineteenth century. Finally, the whole issue can be demonstrated as having become inextricably entwined with internal policies of reform which sought to strengthen the government of Iran by centralisation and growing taxation on those who were hitherto exempt. This movement, however, which occurs late in the period, that is to say in the early twentieth century, was to stall during its very weak second decade. Despite the significance of the subject of foreign land ownership and tenancies in Iran in the Qajar period, no detailed study of it exists. Issawi notes that there was a considerable amount of land purchase in Astarabad, Gilan and Azerbaijan byRussian subjects,who became settled there during the second half of the nineteenth century.2 In 1864 Eastwick observed that Gilan was the residence of a large number of Russian prot́eǵees.3 They were especially dominant in Rasht, where they held entire villages by right of mortgage. However, as will be shown, the picture was more complex than it appeared, it varied from region to region, and in particular there was a contrast between the north and the British-dominated south. The nature of the claims of foreigners on land also evolved over time, much depending on the impact of the central government and of foreign trade. Within this framework the present study sets out to examine broadly the ways in which land was acquired between the signing of the Treaty of Turkmanchai in 1828 and the breakdown of Iranian government central control by 1911. It will consider not only claims and ownership themselves, but also the ways in which land was acquired and by what rights, including the legal arguments deployed for and against foreign ownership and leaseholds. It is hoped that the article will thereby trace changes in Iran both in terms of foreign relationships and influence, and in internal development. © 2011 The Royal Asiatic Society.
Journal de la Societe des Americanistes (19577842)97(1)pp. 339-357
Amazonian indigenous peoples have preserved many aspects of their culture and cosmology while also developing complex relationships with dominant non-indigenous society. Until now, anthropological writing on Amazonian peoples has been divided between "traditional" topics like kinship, cosmology, ritual, and myth, on the one hand, and the analysis of their struggles with the nation-state on the other. What has been lacking is work that bridges these two approaches and takes into consideration the meaning of relationships with the state from an indigenous perspective. That long-standing dichotomy is challenged in this new ethnography by anthropologist José Kelly. Kelly places the study of culture and cosmology squarely within the context of the modern nation-state and its institutions. He explores Indian-white relations as seen through the operation of a state-run health system among the indigenous Yanomami of southern Venezuela. With theoretical foundations in the fields of medical and Amazonian anthropology, Kelly sheds light on how Amerindian cosmology shapes concepts of the state at the community level. The result is a symmetrical anthropology that treats white and Amerindian perceptions of each other within a single theoretical framework, thus expanding our understanding of each group and its influences on the other. This book will be valuable to those studying Amazonian peoples, medical anthropology, development studies, and Latin America. Its new takes on theory and methodology make it ideal for classroom use. © 2011 The Arizona Board of Regents. All rights reserved.
Journal Of Research In Medical Sciences (17357136)16(12)pp. 1590-1597
BACKGROUND: The aim of this study was to compare the efficacy of azithromycin vs. fluticasone in treatment of adenotonsillar hypertrophy (AH). METHODS: In a clinical trial, 39 AH patients were selected using a convenient time-based sequential sampling method. The subjects were randomized into two treatment groups. Patients in group A (fluticasone) and B (azithromycin) were respectively treated with fluticasone spray and azithromycin suspension for a 6-week period. Data regarding the grade of obstruction (based on tonsillar size), level of adenotonsillar hypertrophy, and obstructive sleep apnea (OSA) symptoms (including mouth breathing, snoring, hyponasal speech, and sleep apnea) were collected by a self-administrated questionnaire before treatment, as well as 1 week and 8 weeks after treatment. RESULTS: Twenty AH patients in group A and 19 AH patients in group B were studied. AH related symptoms, including mouth breathing, snoring, hyponasal speech and sleep apnea, improved significantly in both groups (p < 0.05). We also found a statistically significant reduced grade of obstruction among patients in both groups. However, fluticasone was not effective on adenotonsillar hypertrophy. One week after treatment, outcomes related to apnea and hyponasal speech were better in group B than group A. Decreases in mouth breathing and snoring were not significantly different between group A and B. CONCLUSIONS: It could explain that though both of the improved and mentioned symptoms comparing within initial status, Azithromycin seems to be more effective than fluticasone in improving AH-related symptoms. Short term efficacy of the antibiotic is much significant than its long term effect.
Journal of Logic and Computation (0955792X)22(5)pp. 1171-1198
Epistemic logics with justification, S4LP and S4LPN, are combinations of the modal epistemic logic S4 and the Logic of Proofs LP, with some connecting principles. These logics together with the modal knowledge operator □F (F is known), contain infinitely many operators of the form t: F (t is a justification for F), where t is a term. Regarding the Realization Theorem of S4, LP is the justification counterpart of S4, in the sense that, every theorem of S4 can be transformed into a theorem of LP (by replacing all occurrences of by suitable terms), and vise versa. In this article, we first introduce a new cut-free sequent calculus LPLG for LP, and then extend it to obtain a cut-free sequent calculus for S4LP and a cut-free hypersequent calculus for S4LPN. All cut elimination theorems are proved syntactically. Moreover, these sequent systems enjoy a weak subformula property. Then, we show that theorems of S4LP can be realized in LP and theorems of S4LPN can be realized in JS5 (the justification counterpart of modal logic S5). Consequently, we prove that S4LP and S4LPN are conservative extensions of LP. © 2011 The Author. Published by Oxford University Press. All rights reserved.
Lecture Notes in Computer Science (including subseries Lecture Notes in Artificial Intelligence and Lecture Notes in Bioinformatics) (03029743)7415pp. 91-108
In this paper, we introduce justification counterparts of distributed knowledge logics. Our justification logics include explicit knowledge operators of the form [[t]] iF and , which are interpreted respectively as "t is a justification that agent i accepts for F", and "t is a justification that all agents implicitly accept for F". We present Kripke style models and prove the completeness theorem. Finally, we give a semantical proof of the realization theorem. © 2012 Springer-Verlag.
Hashemipour, M.,
Hovsepian, S.,
Hashemi, S.M.,
Amini, M.,
Kelishadi, R.,
Sadeghi, S. Iranian Journal Of Pediatrics (20082150)22(1)pp. 92-96
Objective: Thyroid hormone is necessary for normal development of the auditory system. The aim of this study was to investigate the rate of hearing impairment in congenitally hypothyroid (CH) patients, and its relation with factors such as CH severity and age at starting treatment, during CH screening program in Isfahan. Methods: Hearing acuity was assessed in two groups of children with (94 patients aged 4 months - 3 years) and without CH (450), between 2000-2006. Otoacostic emission (OAE) was performed by a two step method. After two tests without OAE signals bilaterally, they were referred for auditory brainstem response (ABR) test. Subjects with both OAE and ABR abnormal test results were considered to have hearing problem. Obtained data was compared in case and control group and also CH patients with and without hearing impairment. Findings: Three (3.2%) of patients and 1 of control group (0.2%) were diagnosed with sensorineural hearing loss. The rate of hearing loss was not different significantly in two studied groups (P>0.05). There was no difference between age of starting treatment and first T4 and TSH level in CH patients with and without hearing loss (P>0.05). CH neonates with hearing impairment had thyroid dyshormonogenesis according to the follow up results. Conclusion: The rate of hearing loss was low among our studied CH patients. It may be due to proper management of CH patients. In view of the fact that all CH neonates were dyshormonogentic and considering the relation between certain gene mutations and hearing impairment in CH patients, further studies with larger sample size, with regard to different etiologies of CH should be investigated to indicate the possible gene mutations related to hearing loss in CH. © 2012 by Pediatrics Center of Excellence, Children's Medical Center, Tehran University of Medical Sciences, All rights reserved.
Mediterranean Journal of Social Sciences (20392117)(2)
Subjects due to their class position may construct specific fantasies. Class fantasy, one of the given fantasies, is constructed by lower-classes in the society. This study is to critically scrutinize this type of fantasy in media discourse data. Furthermore, as ideology is a means by which cinema apparatus sutures audience within movie narration, the movie ideology and its relation with the given fantasy will be discussed as well. Indeed, the paper presents an attempt to illustrate how movies, through the construction of the fantasy, serve to justify the prevailing ideologies at the time. A case in point is melodrama. The data are extracted from one the most popular movies in the history of Iranian cinema, Ganj-e Qaroon (meaning Qaroon's Treasure). Analysis of the data is done within the frameworks of Bordwell (1995); Cormack (1992); and Zizek (2008a). Findings show that the class fantasy is constructed through the movie. That is the hero, reaching the object-cause of desire namely the girl of narration, may fill the class gap; however, a change in his position causes the object to lose its significance. Concerning the movie ideology, results indicate that the movie ideology, i.e. the class ideology, proposes class coexistence in peace. Indeed, the movie not only represents class fantasy but also uses the end of fantasy in its favor.
Iranian Journal Of Otorhinolaryngology (22517251)24(69)pp. 181-186
Introduction: To study the long-term complications of tympanostomy tube insertion in young children 10 years after surgery. Materials and Methods: In September 2011, the medical records of all patients who had undergone myringotomy with tympanostomy tube insertion between February 2000 and March 2001 at the two general hospitals of Isfahan University of Medical Sciences were studied. Of the 98 patients who fulfilled the inclusion criteria, 82 patients agreed to participate and were enrolled in the study. The complications of the operation were evaluated in these patients. Results: Of the 164 ears that were operated on, myringosclerosis was found in 17.1%, atrophy of the tympanic membrane in 1.2%, permanent perforation of the tympanic membrane in 0.6% and tympanic membrane atelectasis in 0.6%. None of the patients developed cholesteatoma as a complication of tympanostomy tube insertion. Conclusion: Considering the low risk of serious complications after 10 years, tympanostomy tube insertion is a safe and effective treatment option in the treatment of otitis media with effusion.
