Ebrahim Karimi

Hearing impairment in pregnancy toxemia

OBJECTIVE: Preeclampsia characterized by widespread endothelial damage and dysfunction, systemic toxicity, coagulation defects, and an increased systemic inflammatory response, poses some risk factors for hearing loss. STUDY DESIGN: A case-control study. SUBJECTS AND METHODS: Two groups with 37 pre-eclamptic and 38 healthy pregnant women were matched by age. Other factors that could possibly influence hearing were ruled out. Transient otoacoustic emission (TEOAE) was carried out for both groups before delivery and was repeated two weeks after delivery in cases of failure. RESULTS: We could not find any abnormality in the healthy pregnant women who underwent the TEOAE test, but five of the preeclamptic women failed the initial test before delivery. This condition was recovered two weeks later. Statistical analysis showed significant difference (TEOAE disturbances) between the two groups (P = 0.025). CONCLUSIONS: This study showed that pregnancy toxemia might have effects on hearing abilities.

Testing a New Anticoagulation Method for Free Flap Reconstruction of Head and Neck Cancers

Objectives Free flaps are widely used to reconstruct head and neck defects. Despite the improvement in the surgical techniques and the surgeons’ experiences, flap failures still occur due to thrombotic occlusion after small vessels anastomosis. To reduce the possibility of flap loss as a result of thrombotic occlusion, various anticoagulants have been used. In this study we decided to evaluate a new protocol for anticoagulation therapy and its effect on flap survival and complications. Methods In this interventional study, 30 patients with head and neck cancer underwent surgical defects were reconstructed by microvascular free flap between 2013 and 2014. In the postoperative period patients have taken aspirin (100 mg/day) for 5 days and enoxaparin (40 mg/day subcutaneously) for 3 days. The flap survival was followed for three weeks. Results Given that there was no complete necrosis or loss of flap, the free flap success rate was as much as 100%. The need for re-exploration occurred in 3 patients (10%). Only in one patient the need for re-exploration was due to problem in venous blood flow. Conclusion The aspirin-enoxaparin short-term protocol may be a good choice after free flap transfer in reconstruction of head and neck surgical defects.

Association between Epstein Barr Virus and Tongue Squamous Cell Carcinoma in Iranian patients

Detection of Epstein-Barr virus in oral squamous cell carcinoma suggests its involvement in the carcinogenesis of oral cavity. But, there are few studies on the incidence of EBV genome in squamous cell carcinomas at specific locations in the oral cavity like tongue and with different tumor progression. In this study the presence of EBV genome in tongue Squamous Cell Carcinoma (TSCC) in Iranian patients were investigated. Accordingly, a total of 94 cases with TSCC were firstly analyzed for the presence of viral genome through Nested PCR. Patients were divided into different groups based on their gender and the size, nodal involvement, grade and stage of their tumor. Results showed the presence of EBV genome in 72.3% of TSCCs with no significant difference between two genders, although slightly higher in females. Interestingly, PCR products of EBV genome showed a statistically significant higher distribution in TSCCs at IVa stage (p=0.04), while a considerable low involvement of EBV genome was seen in T1-sized tumors. The result of this study further emphasizes the role of EBV in oral SCCs - mainly at tongue. This is the first investigation to clarify the association between EBV genome and different tumor size and stage in TSCCs; however, more studies in different regions and larger populations should be performed to be able to draw a firmed conclusion.