Mehrdad Jafari - Academia.edu (original) (raw)

Papers by Mehrdad Jafari

Oxford Medical Case Reports

Mucormycosis is an opportunistic fungal infection caused by fungi of Mucorale order. Uncontrolled... more Mucormycosis is an opportunistic fungal infection caused by fungi of Mucorale order. Uncontrolled diabetes mellitus and other immunosuppressive conditions such as neutropenia and corticosteroid therapy are known risk factors. A new risk factor for this infection is COVID-19 which facilitates mucormycosis by different mechanisms. The rhino-orbito-cerebral involvement is the most common form. Involvement of other anatomical regions may occur in rare situations. As we presented here, a 51-year-old woman presented with respiratory distress and subglottic lesion during COVID-19 (Delta variant) treatment which was diagnosed by histopathological examination as a subglottic mucormycosis postoperatively. The patient underwent tracheostomy and debridement of the necrotic tissues followed by antifungal treatment. New manifestations of COVID-19 are appearing over time. The association between coronavirus and mucormycosis of the laryngeal and airway region must be given serious consideration. Cu...

Journal of Plastic, Reconstructive & Aesthetic Surgery

ACTA MEDICA IRANICA

The aim of this non-randomized clinical trial was to evaluate tumor outcomes and subjective quali... more The aim of this non-randomized clinical trial was to evaluate tumor outcomes and subjective quality of voice following radiotherapy and partial laryngectomy in early-stage glottic laryngeal cancers. Non-Randomized Clinical Trial. Otolaryngology and radiation oncology clinics of Imam Khomeini (an affiliated hospital of Tehran University of Medical Sciences) and Amir Aalam Hospitals. Fifteen patients with early-stage glottic laryngeal carcinoma were admitted to the otolaryngology clinic, divided into two treatment groups: radiotherapy and partial laryngectomy. Of the total 50 patients, 25 had a partial laryngectomy and 25 radiotherapies. The comparison of the average of the Voice Handicap Index (VHI) showed significant improvement of vocal quality after treatment for both partial laryngectomy and radiotherapy (P<0.0001 for both). But there was no significant difference in VHI mean scores between the two treatment groups (patients treated by partial laryngectomy and radiotherapy). S...

Caspian Journal of Internal Medicine, 2021

Background: Neuromyelitis optica spectrum disorder (NMOSD) is a neuroinflammatory disorder with a... more Background: Neuromyelitis optica spectrum disorder (NMOSD) is a neuroinflammatory disorder with a tendency to affect the spinal cord and optic nerves. As NMOSDs have a predilection for women of reproductive age and adopt an aggressive course during pregnancy, appropriate treatment strategies before conception and during pregnancy should be well-considered. Case Presentation: In this report, the pregnancy outcome of eight pregnancies following rituximab treatment was assessed, which led to 50% live births with mean birth weight of 2777.50 (SD: 545.92) grams. Two patients had abortions due to doctor’s recommendation. One pregnancy led to intrauterine fetal death (IUFD) due to nuchal cord. No spontaneous abortions were encountered. Two patients received rituximab during pregnancy. No major malformations or serious neonatal infections were encountered. Conclusion: Rituximab should be administered by caution in NMOSD patients who want to be pregnant and the probable adverse effects of th...

British Journal of Oral and Maxillofacial Surgery, 2021

This study was intended to describe the technique used and the results obtained with the modifica... more This study was intended to describe the technique used and the results obtained with the modification of the infrahyoid flap (IHF) for the reconstruction of oral tongue defects following resection for advanced squamous cell carcinoma (SCC). Patients with oral tongue defects following ablation for T2 to T4a SCC had reconstructions using a modified infrahyoid flap. Demographic data, tumour characteristics, and the complications were evaluated for each patient. We observed no complications regarding the healing process of the donor site or success of the flap in 49 (of 55) patients. None of the flaps had massive oedema or venous congestion in the postoperative period. Six patients experienced flap-related complications of which five had partial skin paddle necrosis, but eventually their flaps recovered and re-epithelialised without any further intervention. However, total flap necrosis was seen in one patient in whom a pectoralis major flap was used for the defect reconstruction following revision surgery. History of previous radiotherapy to the neck (p = 0.003), tumour stage (p = 0.017), and metastasis to cervical lymph nodes (p = 0.004) were associated with higher prevalence of partial or total flap necrosis. The modified infrahyoid flap is a reliable, quick, and simple procedure with a reasonable cost that makes it a valuable option for the reconstruction of the oropharynx and oral cavity with minimal donor site morbidity and good outcomes. It seems the modified IHF is a valid surgical procedure that may be considered in selected patients undergoing reconstruction of oncological oral tongue defects with fewer complications.

Dermatology Research and Practice, 2021

Background. The increasing incidence of skin cancers in fair-skinned population and its relativel... more Background. The increasing incidence of skin cancers in fair-skinned population and its relatively good response to treatment make its accurate diagnosis of great importance. We evaluated the accuracy of clinical diagnosis of malignant skin lesions by comparing the clinical diagnosis with histological diagnosis as the gold standard. Materials and Methods. In this retrospective study, we assessed all the pathology reports from specimens sent to a university hospital laboratory in 3 consecutive years from March 2008 to March 2010. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and positive and negative likelihood ratios were calculated for clinical diagnosis of malignant skin lesions stratified by their histological subtype. Results. A total 4,123 specimen were evaluated. The sensitivity and specificity for clinical diagnosis of malignancy were 90.48% and 82.85%, respectively, whereas the negative predictive value was shown to be 99.06%. Th...

Case Reports in Neurological Medicine, 2021

Neurologic manifestations are increasingly reported as the coronavirus disease 2019 (COVID-19) pa... more Neurologic manifestations are increasingly reported as the coronavirus disease 2019 (COVID-19) pandemic continues. This is a report of a COVID-19 patient with Bell's palsy. Case Summary. A 52-year-old man with fever and malaise was tested positive for COVID-19. After a week, he developed right-sided peripheral facial palsy and was treated with corticosteroids in conjunction with antiviral treatment which resulted in complete recovery. Discussion. Concomitant treatment of corticosteroids and antiviral treatment can decrease morbidity in patients with COVID-19-related Bell's palsy.

Background: Patients often name post-operative pain as the most horrifying aspect of the surgery.... more Background: Patients often name post-operative pain as the most horrifying aspect of the surgery. The purpose of this study was to evaluate the effect of communication with patients on post-operative pain and agitation in the patients recovering from endoscopic sinus surgery. Methods: This was a randomized clinical trial. Sixty patients scheduled for endoscopic sinus surgery were randomly allocated to control and intervention groups (30 patients in each group). A supportive and informative session was established for 20-30 minutes in two stages for the intervention group while the control group received routine information. After surgery, pain and agitation were assessed using the non-verbal pain scale, visual analog scale and Riker's sedation-agitation score. Results: The average pain scores in the recovery room by non-verbal pain scale and visual analog scale were (3.4±1.6) and (6.2±3.0) for the control group and (1.2±1.5) and (3.0±3.3) for the intervention group, respectively...

Indian Journal of Otolaryngology and Head & Neck Surgery, 2021

Chronic otitis media (COM) is a common disease that can cause damage to the middle ear ossicles a... more Chronic otitis media (COM) is a common disease that can cause damage to the middle ear ossicles and thus lead to conductive hearing loss. The purpose of this study was to compare two methods of incus partial ossicular reconstruction prosthesis (PORP) and reconstruction with titanium angular clip prosthesis in patients with incudostapedial joint erosion. In this interventional randomized clinical trial carried out in a tertiary referral hospital, patients with chronic otitis media and incudostapedial joint erosion who were candidates for surgery, were randomly allocated into two groups of incus PORP surgery and reconstruction with a titanium angular clip prosthesis. Audiometry was performed for the patients prior to and six months after surgery. Pre-and post-operative air-bone gap (ABG) and bone conduction (BC) thresholds were calculated and means were compared by analysis of variances (ANOVA). A P value of \0.05 was considered statistically significant. The study consisted of 24 and 14 subjects in the incus PORP and angular clip groups, respectively. There was no statistically significant difference between the mean pre-and post-operative ABG, BC thresholds and ABG reduction in the compared groups. Considering issues such as high cost and inaccessibility of titanium angular clips in all centers, incus PORP may be a more acceptable method.

Background: Malignant epithelial sinonasal tumors are a rare group of head and neck cancers with ... more Background: Malignant epithelial sinonasal tumors are a rare group of head and neck cancers with various histological subtypes that can affect the treatment outcomes in the locally advanced tumors.Our aim was to investigate the relationship between oncological outcomes and histological type in sinonasal carcinomas.Material and Method: In this retrospective cohort study we retrieved patients’ information from medical archives. Most of patients underwent surgery and all received radiation as indicated, some patients received chemotherapy. We evaluated 3-year overall survival (OS),distant metastases and local recurrence according to histological type.Results: We studied 28 patients between 2011-2016. Most of them were male. Squamouse cell carcinoma (SCC) was found in 15 (53.5%), Adenoid cystic carcinoma (AdCC) in 8 (28.5%), and Adenocarcinoma (AC) in 5 (18%) patients. The highest rate of metastasis was observed in AC. Three-year OS were 48%, 50% and 73% in SCC, AC and AdCC respectively...

OTO Open, 2018

Objective The purpose of this study was to discuss the clinical outcomes and complications of tre... more Objective The purpose of this study was to discuss the clinical outcomes and complications of treating venous malformations with sclerotherapy, with sodium tetradecyl sulfate as the sclerosing agent. Study Design Case series with planned data collection. Setting Amiralam Hospital—a referral otolaryngology–head and neck surgery hospital affiliated with Tehran University of Medical Sciences. Subjects and Methods A total of 345 patients with venous malformations were treated with sclerotherapy with sodium tetradecyl sulfate 3% (1 mL for every 1 cm3 of the lesion). The venous malformation location, treatments before the current sclerotherapy with sodium tetradecyl sulfate, the number of sclerotherapy sessions, and complications resulting from sclerotherapy were recorded. Follow-up assessments were done for a minimum of 1 year following the procedure. A favorable outcome was defined as a 50% decrease in the lesion size based on clinical and radiologic assessments. Results A total of 759 ...

Journal of Oral and Maxillofacial Surgery, 2015

To describe the authors' experience in the reconstruction of patients after total maxillectomy wi... more To describe the authors' experience in the reconstruction of patients after total maxillectomy with preservation of orbital contents for maxillary tumors using titanium mesh and autogenous fascia lata, where no setting for free flap reconstruction is available. Patients and Methods: Twelve consecutive patients with paranasal sinus tumors underwent total maxillectomy without orbital exenterations and primary reconstruction. The defects were reconstructed by titanium mesh in combination with autogenous fascia lata in the orbital floor performed by 1 surgical team. Titanium mesh (0.2 mm thick) was contoured and fixed to reconstruct the orbital floor and obtain midface projection. Fascia lata was used to cover the titanium mesh along the orbital floor to prevent fat entrapment in the mesh holes. Results: The most common pathology was squamous cell carcinoma (50%). Patients' mean age was 45.66 years (33 to 74 yr). The mean follow-up period was 35.2 months (30 to 49 months). During follow-up, no infection or foreign body reaction was encountered. Extrusion of titanium mesh occurred in 4 patients who underwent postoperative radiotherapy. Two cases of mild diplopia at extreme gaze occurred early during the postoperative period that resolved after a few months. Conclusion: Placing fascia lata between the titanium mesh surface of the orbital implant and the orbital contents was successful in preventing long-term diplopia or dystopia. Nevertheless, exposure of the titanium implant through the skin surface represented a complication of this technique in 25% of patients. Further studies are required with head-to-head comparisons of artificial materials and free flaps for reconstruction of maxillectomy defects.

Ostomy/wound management, 2009

Although the literature contains evidence demonstrating the beneficial effects of insulin on woun... more Although the literature contains evidence demonstrating the beneficial effects of insulin on wound healing, no suitable method for the routine administration of insulin has been reported. A randomized, double-blind, placebo-controlled trial was conducted to determine the safety and efficacy of topical insulin on healing in 45 patients (29 men, mean age for both groups 40.62 years, range 12 to 71 years) with noninfected acute and chronic extremity wounds. Patients were randomly assigned to twice-daily topical application (spray) of 1 cc saline 0.9% for each 10 cm2 of wound with or without 10 units (0.1 cc) of insulin crystal and insulin. The endpoint was complete wound closure. Systemic glucose levels were measured before and 1 hour after treatment application. No patients developed signs or symptoms of hypoglycemia and glucose levels pre- and post-application did not differ significantly. Time to healing did not differ significantly between treatment groups. Healing rates were affec...

National Journal of Maxillofacial Surgery, 2010

Pain as a frequent occurrence after dental procedures concerns patients and has an adverse impact... more Pain as a frequent occurrence after dental procedures concerns patients and has an adverse impact on patient satisfaction. [1] Third molar post extraction pain (PEP) is one of the most common models successfully used in recent years for assessing the analgesic efficacy of pain-killing drugs. [2,3] Pain is a subjective experience influenced by many factors such as patient age, cultural and educational level, past experiences, pain threshold and tolerance which makes its objective assessment difficult. Despite these limitations, a visual analog scale (VAS) is universally considered to be the most appropriate instrument for pain measurement and is the most widely used means for scoring postoperative painand specifically that caused by the surgical extraction of the lower third molar. [4-6] The literature has it that many factors are related to PEP (such as patient age, surgical parameters, number of sutures, degree of impaction, etc.). Some have strong supporting evidence Confirming their relationship while some are still mired in controversy. Most of the literature focuses little attention on the patient and surgical factors that influence third molar PEP. [7] However, one of the most important factors regulating oral health is saliva. [8] For diagnostic and prognostic purposes, routine dental practice should therefore

Basic & Clinical Pharmacology & Toxicology, 2008

Administration of N-acetylcysteine may be effective in diseases caused by oxidative-antioxidative... more Administration of N-acetylcysteine may be effective in diseases caused by oxidative-antioxidative imbalance. We aimed to determine the effect administration for 4 months of N-acetylcysteine (1200 mg daily) on sulfur mustard-induced bronchiolitis obliterans in patients with normal pulmonary function test. In a double-blind clinical trial, 144 patients with bronchiolitis obliterans due to sulfur mustard and bronchiolitis obliterans syndrome class 0, randomly entered to group 1 (n = 72, N-acetylcysteine) and group 2 (n = 72, placebo). The changes in dyspnoea, wake-up dyspnoea, cough and sputum were measured after 4 months using a 'delta value' (i.e. symptom score after 4 months-symptom score before the trial). Spirometric findings were measured at the beginning of the trial, 2 months later and 4 months later. Dyspnoea (delta value:-0.78 (0.61), P < 0.001), wake-up dyspnoea (delta value:-0.57 (0.64), P < 0.001), and cough (delta value:-0.86 (0.63), P < 0.001) improved after 4 months of N-acetylcysteine administration compared to the control group. N-acetylcysteine reduced sputum from 76.9% (n = 40) of cases before the trial to 9.6% (n = 5) of cases after the trial. Spirometric components were significantly improved in N-acetylcysteine group compared to the placebo group: FEV1 (P < 0.0001), FVC (P = 0.014) and FEV1/FVC (P = 0.003). A 4-month trial with 1200 mg oral N-acetylcysteine per day can be used for treating bronchitis, but is also effective in treating bronchiolitis. It also prevents sulfur mustard-induced oxidative stress, and can be used in the treatment of sulfur mustard-induced pulmonary disease.

Aesthetic Surgery Journal, 2014

Functional and aesthetic nasal surgeries are inextricably linked. This fact has become increasing... more Functional and aesthetic nasal surgeries are inextricably linked. This fact has become increasingly evident within the past decade, during which the principle of tissue conservation has permeated the surgical philosophy of reductive rhinoplasty. 1,2 Tissue conservation has been primarily adopted within the domain of dorsal reduction surgery, yet the same principles hold true in tip modification, or tipplasty. 3 For instance, emphasis was once placed on tip reduction techniques that achieved short-term and cosmetic goals-often at the expense of harm to the support mechanisms of the tip. As knowledge of the structural and dynamic roles of cartilaginous tip support has grown, a better understanding has developed of the consequences that surgical modifications may have on dynamic nasal airflow. 1,2