Seyed Mohammad Javad Hosseini; Jaleh Yousefi; Habib Yaribeygi; Gholam Hossein Alishiri
Abstract
Introduction: Cranial nerve palsy in Wegener’s granulomatosis is a curious incident, particularly if it occurs without kidney or lung involvement. In a review of medical articles, only 1 case of Wegener’s granulomatosis with bilateral facial nerve palsy was found. Case Presentation: The patient ...
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Introduction: Cranial nerve palsy in Wegener’s granulomatosis is a curious incident, particularly if it occurs without kidney or lung involvement. In a review of medical articles, only 1 case of Wegener’s granulomatosis with bilateral facial nerve palsy was found. Case Presentation: The patient was a 16-year-old female who presented with pain and hearing loss in both ears and reduced muscle tone in the right side of her face. After myringotomy and ventilation tube embedding in both ears, she gradually developed infectious otorrhea in both ears. Despite antibiotic and antifungal therapy for 2 weeks after surgery, the patient developed paresis in the left facial nerve and gag reflex disorder. Both magnetic resonance imaging (MRI) and magnetic resonance venography (MRV) tests were normal, but the C-anti-neutrophil cytoplasmic antibody (CANCA) test result was about forty times higher than normal, and a sinus biopsy also verified Wegener’s granulomatosis. The patient was then treated with pulse corticosteroid and cyclophosphamide therapy. Her gag reflex healed and the ear secretions stopped, but the facial nerve palsy continued. Conclusion: Although cranial nerve involvement in Wegener’s granulomatosis is an unusual incidence, it may occur in some cases. In the current case, otitis media and cranial nerve paresis without kidney or lung disorders were the only signs of disease onset; of course, computerized tomography (CT) scan revealed a right mandibular sinus disorder without any clinical signs. Another important point in this case is that other identified Wegener’s patients were in their fourth or fifth decade of life; thus, Wegener’s was the last choice for a diagnosis in the current case.
Habib Yaribeygi; Mohammad Javad Hosseini; Hamid Rokhsarizadeh; Gholam Hossein Meftahi; Mahmoud Salesi
Abstract
Background: Intravenous catheterization is a routine technique in medical centers which can cause diverse problems such as thrombophlebitis. Objective: This study aimed to resolve replacement scheduling and proper cannula diameter and position issues for intravenous catheters. Methods: In this 2015 experimental ...
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Background: Intravenous catheterization is a routine technique in medical centers which can cause diverse problems such as thrombophlebitis. Objective: This study aimed to resolve replacement scheduling and proper cannula diameter and position issues for intravenous catheters. Methods: In this 2015 experimental cohort study, 232 hospitalized patients receiving medication intravenously were assessed for the occurrence of thrombophlebitis (TF). Involved TF factors such as age, gender, cannula size, site of cannula in hand veins, duration of usage, and underlying disease were evaluated in patient and healthy control groups. Results: TF developed in 55 of 232 patients. The percentages of incidence were similar in men and women (30%). The patient mean age was lower than that of the control, but the difference was not significant. Average weight was significantly higher in the patient group than in the control group. The average duration of cannula in situ was significantly lower in patients than in the control group. The highest rate of TF occurred in the narrowest cannula usage and dorsal hand vein positions. The mean time of developing TF was lower than that indicated in CDC guidelines. Furthermore, 24 patients with TF (34%) had diabetes mellitus. Conclusion: In the current study, the percentage of TF occurrence was higher in patients with weight increase, use of narrower cannulae, dorsal hand vein positions, and a history of diabetes. Furthermore, TF can develop within 72 hours. It was concluded that some patients may be more susceptible to TF and require more care. Accordingly, the CDC guidelines’ offered scheduling for intravenous catheter replacement is not trustworthy.