Review Article
Medicine
Khosro Kolahdouzan; Behrooz Nazari
Abstract
Ankle arthroplasty and total ankle arthroplasty are two important treatments for end-stage degenerative ball. Its results on the biomechanics of the medial foot are not sufficient to determine which is better. This study compared the biomechanical parameters of feet treated with ankle arthrodesis, feet ...
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Ankle arthroplasty and total ankle arthroplasty are two important treatments for end-stage degenerative ball. Its results on the biomechanics of the medial foot are not sufficient to determine which is better. This study compared the biomechanical parameters of feet treated with ankle arthrodesis, feet treated with total ankle arthroplasty, and healthy feet using statistical analysis. A validated tripod finite element model was designed to simulate the stance phase of gait. The results showed that total ankle arthroplasty provides more stable plantar pressure distribution than ankle arthrodesis. Among all replacements, the mean scaphoid joint had the highest contact pressure of 3.17 MPa. Surgery does not result in deep subscalar fusion. In both surgical models, an increase was achieved in the maximum metatarsals, especially in the second and third metatarsals. This study allows us to look at the internal biomechanics of foot defects and feet treated with total ankle arthroplasty and ankle arthrodesis during walking.
Original Article
Medicine
Abdolreza Mehdinavaz Aghdam; Fariborz Rousta
Abstract
Introduction: Another rare surgical cause of voice change after thyroidectomy is cervical muscle injury Causes of failure may include pulmonary edema, edema, or airway obstruction. The aim of this study was to determine the frequency of unplanned parathyroidectomy, unplanned parathyroidectomy, postoperative ...
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Introduction: Another rare surgical cause of voice change after thyroidectomy is cervical muscle injury Causes of failure may include pulmonary edema, edema, or airway obstruction. The aim of this study was to determine the frequency of unplanned parathyroidectomy, unplanned parathyroidectomy, postoperative hypocalcemia and the risk of unplanned parathyroidectomy in patients undergoing thyroid surgery in our clinic. Material and Methods: Comparison of postoperative Ca value with age, gender, preoperative Ca value, dominant nodule diameter on ultrasonography (USG), type of surgery (total/lobectomy), and histopathological findings of thyroidectomy material (malignant/benign, with or without incident parathyroidectomy) is closed. Blood calcium levels below 8 mg/dL, measured after the first 24 hours after surgery, are indicative of postoperative hypocalcemia. Results: There was no relationship between nodule diameter and hypocalcemia. When patients were divided into malignant and benign groups, there was no significant difference between these groups in terms of performance after hypocalcemia. When patients were divided into groups with and without incident parathyroidectomy, there was no significant difference in postoperative hypocalcemia between these groups. Conclusion: In our study, female gender, age <28.5 years, low preoperative Ca value and total thyroidectomy were considered to be associated with hypocalcemia. Although there is no association between parathyroidectomy and postoperative hypocalcemia, this problem can be avoided by careful removal and imaging of the thyroid gland, especially in patients including patients with malignant thyroidectomy and total thyroidectomy.
Original Article
Medicine
Khosrow Hashemzadeh; Marjan Dehdilan
Abstract
Introduction: Our aim was to record preoperative and postoperative results in patients undergoing coronary artery bypass grafting, to examine the factors affecting reoperation, and to determine whether there is a gender difference in pre- and post-activity activity using the Duke Activity Status Index. ...
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Introduction: Our aim was to record preoperative and postoperative results in patients undergoing coronary artery bypass grafting, to examine the factors affecting reoperation, and to determine whether there is a gender difference in pre- and post-activity activity using the Duke Activity Status Index. Material and Methods: 151 patients who underwent isolated coronary artery bypass grafting. The median time from baseline to return to work after Duke Success for women and men was 8.0 months. In addition to baseline scores at postoperative follow-up, the effects of 47 variables were analyzed with logistic ordinal models. The appropriate model for subsequent scores was determined by reverse selection, keeping the variables if they met the criteria for a P-value less than 0.05.Results: Average scores on the Duke Activity Status Index (women, 21.5; men, 32.2; P < .001) and pretest scores (42.7 for women; 58.2 for men; P < .001) were lower in women than in men. Postoperative scores were lower in elderly patients with obstructive pulmonary disease, myocardial infarction, stroke, diabetes, vascular disease, severe postoperative pain, and return to the operating room. After adjusting for these factors, recovery scores remained lower for women (difference from men, 2.1 [95% confidence interval, 1.7-2.6]; P < .001).Conclusion: A number of preoperative, surgical variables, and postoperative factors are associated with functional recovery after coronary revascularization. Additionally, after adjusting for these variables, female sexuality was later associated with lower performance.
Original Article
Medicine
Marjan Dehdilan; Khosrow Hashemzadeh
Abstract
Introduction: In adults, readmission within 30 days of heart surgery is a major factor in hospital costs for heart surgery, but current data on risk factors for readmission are scarce. Therefore, we sought to identify performance-adjusted risk factors for coronary artery bypass graft (CABG) re-admissions.Material ...
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Introduction: In adults, readmission within 30 days of heart surgery is a major factor in hospital costs for heart surgery, but current data on risk factors for readmission are scarce. Therefore, we sought to identify performance-adjusted risk factors for coronary artery bypass graft (CABG) re-admissions.Material and Methods: The records of patients who underwent CABG at our institution between 2012-14 were analyzed for contrast with prospectively recorded case studies, including New York Cardiac Surgery Reporting System (CSRS) events, prescriptions, and testing costs.Results: Read rate 13% ; The CSRS estimated value is 8.7% (observed/predicted ratio = 1.5). The median time from CABG discharge to readmission was 6 days (interquartile range [IQ] 3 to 13 days). The median length of hospital stay was 4 days (IQ 2 to 7 days). The most common causes of readmission were heart disease (n = 40 [25% of readmissions]) and pneumonia (n = 36 [23%]), including pleural effusions. In addition to CSRS status, serum creatinine excretion alone was not associated with increased readings (p=0.5) OR] 5.7, %95 GA 1.7 ila 18.7).Conclusion: Readmission for coronary artery bypass surgery remains an ongoing medical challenge. Given that readmissions usually occur within the first week after discharge and are usually short-term, attention is paid to follow-up care and risk of readmission (compare, for example, abnormal serum creatinine or abnormal reactivity) and/or multiple causes of readmission. may reduce readmission after CABG (eg, pleural effusion).
Review Article
Medicine
Mohammad Irajian; Vahid Fattahi
Abstract
Introduction: Regional anesthesia is considered an important tool in postoperative pain management while minimizing opioid use. However, post-operative recovery (characterized by peripheral nerve hyperalgesia) may reduce or completely block the effect of this change, since opioids may act better after ...
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Introduction: Regional anesthesia is considered an important tool in postoperative pain management while minimizing opioid use. However, post-operative recovery (characterized by peripheral nerve hyperalgesia) may reduce or completely block the effect of this change, since opioids may act better after the blockage is removed.Material and Methods: This study was a systematic Review. We reviewed the published literature describing the pathophysiology and development of complications after peripheral artery dissection in orthopedic surgery patients. Search for related articles using PubMed, EMBASE, and Web of Science.Results: We included 28 articles (n=28) in our review. Perioperative peripheral nerve considerations and other postoperative pain management for orthopedic surgery patients are discussed. Multimodal strategies such as preemptive analgesia, intra-articular or intravenous anti-inflammatory drugs, and adjuvants in vain block fluid before block failure will reduce the burden of rebound pain.Conclusion: Additionally, educating the patient about the possibility of back pain is important to ensure proper use of pain relievers and to reduce the need for pain relief opioids. Understanding the effects of relapse and prevention of relapse is important to reduce the side effects associated with the use of opioids for regional anesthesia.
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