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1.
Iran J Otorhinolaryngol ; 25(72): 147-54, 2013 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-24303435

RESUMO

INTRODUCTION: Epistaxis is one of the most common medical emergencies, making the management of posterior epistaxis a challenging problem for the ear, nose, and throat (ENT) surgeon. In the cases of conservative management failure, ligation of the major arteries or percutaneous embolization of the maxillary artery is performed routinely in most units, but rates of failure and complications are high. The objective of this study was to assess the effectiveness of endoscopic sphenopalatine artery (SPA) cauterization in patients with refractory posterior epistaxis. MATERIALS AND METHODS: Between April 2011 and January 2012, 27 patients (15 males and 12 females) with refractory posterior epistaxis underwent endoscopic SPA cauterization in two tertiary referral hospitals in Shiraz. Three patients underwent bilateral cauterization. RESULTS: Four patients (from 30 arteries) had new epistaxis after surgery, three experienced subsequent epistaxis requiring medical treatment, and one patient had a minor epistaxis not needing treatment. CONCLUSION: The SPA electrocoagulation technique seems to be safe, simple, fast, and effective with low rates of morbidity and complications for the management of refractory posterior epistaxis. Endoscopic SPA cauterization should be considered as an immediate second-line management when conservative treatment as first-line management fails.

2.
J Res Med Sci ; 17(2): 190-6, 2012 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-23264797

RESUMO

BACKGROUND: Despite its inevitable significance, the effect of in-service English education on medical professionals has rarely been studied longitudinally. The reason can be issues such as physicians' heavy workload, commuting problems, inappropriate class times, and inexperienced teaching staff. MATERIALS AND METHODS: A needs assessment worksheet was administered to faculty members of Shahid Beheshti University of Medical Sciences in Tehran and the responses were analyzed. A project for the promotion of faculty members' English proficiency was formulated. Then, following a placement test, 235 applicants from the university colleges and hospitals were classified into 28 homogeneous groups. After four terms of instruction, the participants' scores on the pre- and post- assessments were analyzed. RESULTS: There was significant improvement in participants' total scores on different communicative skills (P<0.001). Regarding individual skills also, they achieved meaningful gains on listening (P<0.001), writing (P = 0.038), and grammar (P<0.001), but failed to progress significantly on reading comprehension (P = 0.523). CONCLUSION: The administration of in-service education for skill-oriented courses, over a long period, can be quite encouraging and should be further strengthened. Regular instructions on each individual skill on the one hand and on their combination on the other are essential for success in such education.

3.
Iran J Med Sci ; 36(3): 196-200, 2011 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-23359623

RESUMO

BACKGROUND: The technique of vertical dome division or tip defining, involves incising the lateral crura and vestibular skin at or lateral to the dome or tip defining point. The incision divides the lower lateral cartilage into a lateral segment and a medial segment, which are advanced anteriorly and sutured together to increase tip projection. The present study aimed at assessing a new vertical dome division, which is a modified version of vertical dome technique to decrease nasal tip projection, and increase or decrease nasal tip rotation and other tip deformities. METHODS: The medical files of patients undergone rhinoplasty from 2003 to 2008 were retrospectively analyzed. The files were selected from a computerized rhinoplasty database of patients, who had been operated using a modified vertical dome technique and followed-up for one year or more after the surgery. RESULTS: A total of 3756 patients were operated. Complications related to the nasal tip such as bossae, bifidity, persistent tip projection or tip asymmetry was seen in 81 patients (2.1%). Revisions for tip-related problems were performed in 42 patients (1.1%). CONCLUSIONS: The findings suggest that the modified vertical dome technique is an effective method for nasal tip deprojection and narrowing via an open approach. The length of follow-up and the large sample size support effectiveness of the technique.

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