Evaluation of the local and systemic pattern of sensitization to allergens in patients with adenotonsillar hypertrophy.

PURPOSE: Adenotonsillar hypertrophy (ATH) is a medical condition characterized by the enlargement or swelling of the tonsils. The role of allergy in ATH has not been persuasively evidenced. Therefore, we investigated the state of humoral immunity and the presence of specific immunoglobulin E (sIgE) in tissues and sera in children suffering from TH. METHODS: According to the skin prick test (SPT) result, 44 ATH children were divided into the atopic and non-atopic groups. The level of sIgE against 30 inhalants and food allergens in the sera and tissue homogenates was measured by a commercial allergy immunoblotting kit. In addition, we evaluated the following variables in both tonsillar tissue homogenates and serum: total IgE, IgA, IgM, IgG, and tissue eosinophil counts. RESULTS: Our results showed that 21 (47.7%) of patients with ATH were sensitized to at least one allergen in the adenotonsillar sample and/or sera. Only two patients were negative for sIgE in the atopic group, but in the non-atopic group, only one had positive sIgE results. In the atopic group, 19 (86.4%) patients had positive sIgE in tonsillar tissues, and 18 (81.8%) had sensitized serum. There were no statistical differences in the case of other antibodies except IgE levels between the two groups. The average eosinophilic count was significantly higher in atopic patients than in the non-atopic group. CONCLUSION: The results of this study support the role of allergy in the pathogenesis of ATH and confirmed local allergic inflammation in tonsillar tissue.

Acute invasive fungal rhinosinusitis: our experience with 18 cases.

Acute invasive fungal rhinosinusitis (AIFRS) is a rapidly progressive life threatening infection that is seen most commonly among immunocompromised patients. We present a case series of 18 patients clinically and histopathologically diagnosed with AIFRS with a mean follow-up of 9.11 ± 2.51 months (range 6-17). Demographic data, apparent symptoms and signs, underlying disorders, and outcomes are discussed. The mean age was 39.56 ± 20.66 years (range 2-75). The most common underlying diseases were diabetes mellitus (50 %) and leukemia (44.44 %). Mucosal biopsy confirmed fungal invasion of the nasal mucosa in all cases. The main fungi were Rhizopus oryzae (55.56 %), Absidia mucor (16.67 %), and Aspergillus fumigatus (27.78 %). Headache and facial pain (77.8 %), facial paresthesia (55.6 %), and ophthalmoplegia (33.3 %) were the most common symptoms and signs. Computed tomography and endoscopic findings showed various stages of sinonasal (100 %), pterygopalatine fossa (55.56 %), orbital (44.45 %), and cerebral (5.56 %) involvement. All patients underwent serial surgical debridement (3.78 ± 1.80 times; range 2-8) simultaneously with systemic antifungal therapy and proper management of the underlying disease. The most extreme case with brain involvement survived and recovered with no evidence of recurrent disease following treatment. All patients were considered cured after two endoscopic negative histopathologic evaluations. Three patients (16.67 %) died, one from uncontrolled leukemia and two due to renal failure. AIFRS is a potentially fatal condition, however, early diagnosis and management of the underlying disease accompanied with systemic antifungal and aggressive serial surgical intervention appears to be effective in reducing mortality in most patients.

Evaluation of some qualitative variations in frozen fillets of beluga (Huso huso) fed by different carbohydrate to lipid ratios.

In this study, juvenile beluga (Huso huso) was fed by the diets containing different carbohydrate to lipid ratios for 5 months. At the end of culture period, proximate compositions of the fish carcasses (moisture, protein, lipid, and ash) were measured. Then, qualitative changes in the fishes were evaluated during 6 months frozen storage (-20 °C) along with recording changes in their Total Volatile Bases Nitrogen (TVN), Thiobarbituric Acid (TBA), Free Fatty Acids (FFA), pH, and muscle texture profile analysis. The results of proximate analysis of the carcasses showed that moisture, protein, and ash of the carcasses increased significantly (p < 0.05) with higher carbohydrate to lipid ratio, but lipid content of the carcasses decreased significantly (p < 0.05). Also, during frozen storage, TVN, TBA, and FFA increased significantly in all the samples (p < 0.05). Significant differences were detected in pH of the treatments (p < 0.05), but these changes didn't follow a regular pattern in all the treatments. The results of muscle texture profile analysis showed lower chewiness, hardness, and gumminess during the first 3 months of frozen storage; however, after 6 month, the values increased significantly compared to those in 3 months. Different characteristics of texture showed significant differences in the treatments during frozen storage (p < 0.05), although these changes didn't follow an identical pattern in all the treatments. It can be concluded that carbohydrate higher than 27% in diet has had adverse effect on quality of fillets during frozen storage. However, lipid levels used in the present study haven't had significant influence on quality of the fillets during the preservation.

Adenoid Cystic Carcinoma with Intracranial Extension.

Adenoid cystic carcinoma (ADCC) is a malignant tumor of salivary gland origin. ADCC of sinonasal tract is rare. We present a rare and unresectable case of sinonasal ADCC with intracranial extension in an 83-year-old man with the chief complaint of nasal congestion. Invasion to the maxillary sinus, nasopharynx, anterior cranial fossa, sella turcica and extension to cavernous sinus, dura mater and infratemporal fossa were evident on MRI and CT scan. The patient was treated only by palliative radiotherapy, but unfortunately, he died 3 months after the initial diagnosis.

Comparison of Blood and Tissue Eosinophil Count and Blood IgE in Patients with Chronic Sinusitis and Nasal Polyps.

BACKGROUND: The inflammatory mucosa of the sinus cavities is called sinusitis and is divided into various types based on its appearance and sign. Chronic rhinosinusitis is an inflammatory-infectious disease that involves the frontal, sphenoid, ethmoid, and maxillary sinuses. Chronic sinusitis is a multifactorial disease and the range of causes varies from environmental factors to genetic factors. The purpose of this study was to compare blood and tissue eosinophils and serum IgE levels in patients with chronic sinusitis with nasal polyp in Vali-e-Asr hospital in 1397. METHODS: In this descriptive-analytical study, the population under study included those with chronic sinusitis referred to Birjand Valiasr Hospital in 1397.3 cc of blood samples were taken 1 day before surgery to evaluate eosinophil counts and serum IgE levels. Also, samples taken from patients during surgery were counted, and then, 100 cells were counted, and eosinophil counts and percentages were calculated. The data were entered into the SPSS software after data collection. RESULTS: This study was performed on 70 patients with chronic rhinosinusitis which included 43 men (61.4%) and 27 women (38.6%) with mean age of 39.11 ± 13 13.72 years. There was no significant difference between sex of patients and mean serum IgE level (P < 0.05). The mean percentage of eosinophils in blood samples and tissues of patients with chronic sinusitis was significantly increased with the increase in CT scan (P < 0.05). CONCLUSIONS: Tissue or blood eosinophilia was not observed in patients with chronic rhinosinusitis. Also, the mean eosinophil percentage of blood and tissue increased significantly in patients with increased scanning computed tomography (P < 0.05).

Survey of Sarcocystis infection in slaughtered cattle in Kerman, Iran.

The parasite of genus Sarcocystis is one of the most commonly found parasite in domestic animals worldwide. Some species of Sarcocystis cause important economic loss when causing clinical and sub clinical disease. The aim of this study was to determine the prevalence of Sarcocystis in slaughtered Cattle in Kerman, Iran. The prevalence of Sarcocystis spp. infection was investigated in 480 cattle, slaughtered from May 2005 to February 2006 in the Kerman, Iran using naked eye examination for macroscopic Sarcocysts, and peptic digestion, muscle squash, squeezing methods for microscopic types. Muscles from heart, tongue, and esophagus, cervical and abdominal muscles of 480 slaughtered cattle were examined for Sarcocystis cysts. The prevalence of microscopic Sarcocystis cysts in cattle was detected in 100% and there was no macroscopic cyst in examined cattle.

Effect of Functional Endoscopic Sinus Surgery on the Voice Quality among Patients with Rhinosinus Polyposis.

INTRODUCTION: Rhinosinus polyposis is associated with voice quality reduction. There has been little evidence about the efficacy of rhinosinus polyps surgery on patients' voice quality so far. The aim of the present study was to evaluate the nasality and acoustic voice changes after rhinosinus polyposis surgery. MATERIALS AND METHODS: The population in this study composed of 30 eligible patients with rhinosinusitis and rhinosinus polyposiss. The functional endoscopic sinus surgery (FESS) was the therapeutic intervention. Acoustic voice parameters were jitter (%), shimmer (db), noise to harmonic ratio (NHR), and fundamental frequency (F0) for the vowels [a, o, e, aa, ie, and ou]. For nasality evaluation, the articulation of vowel [a] was examined using nasometer device. The changes regarding the patients' voice were evaluated one day before and one month after the surgery. RESULTS: The mean age of the participants was 41.2±14.3 years. Considering gender distribution, 20 (66.7%) subjects were men. After the operation, the nasality increased significantly from 40.8% to 74.3% (P<0.001). In addition, the findings revealed the increase of shimmer and F0 (P>0.05). On the other hand, jitter and NHR changes were insignificant. CONCLUSION: The findings of the current study showed that hyponasality decreased a month after the treatment of rhinosinus polyposis with FESS. However, the acoustic quality of voice had no significant changes after the surgery.

Islamic Attitudes and Rhinoplasty.

INTRODUCTION: Although the psychological aspects of rhinoplasty have been fully investigated in the medical literature, the religiosity of rhinoplasty candidates has not been taken into consideration. MATERIALS AND METHODS: In this cross-sectional study, the religious attitudes of 157 rhinoplasty candidates were compared with those of 74 subjects who had not requested rhinoplasty. A domestic validated reliable questionnaire was completed by all subjects to classify them with respect to religious attitude. Other factors such as age, sex and economic and educational status were also taken into consideration. From the surgeon's perspective, subjects were put into three categories: subjects who had a relative indication for rhinoplasty (Category.1), subjects with a well-defined nose based on accepted standards of facial aesthetic analysis (Category.2) and finally subjects with a severely deformed nose, such as deviated nose or nasal cleft lip deformity (Category.3). RESULTS: The mean age among subjects was 28.63 ± 7.05 years, and the majority were female (87%). The two groups of participants (those who did and did not express a desire for rhinoplasty) were analyzed from the point view of age, sex, economic and educational status. The economic and educational status of the two groups did not differ significantly (P>0.05). The religious score showed a significant difference between those who were interested in rhinoplasty (122.75±23.49) and those were not interested (138.78±21.85; P<0.001). CONCLUSION: Religion may affect a patient's decision to undergo rhinoplasty surgery, such that persons with a higher religious attitude tend to undertake it less often. However, individuals with major nasal deformities tend to decide undertake the surgery, irrespective of religious beliefs.