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.
Covid
Abdolreza Mehdinavaz Aghdam; Fariborz Rousta
Abstract
Introduction: The aim of this study was to determine the outcome of low PTH after surgery and to monitor parathyroid recovery times in patients who underwent total thyroidectomy. Material and Methods: A commercially available PTH (iPTH) test was used to monitor iPTH levels on days 1 and 4. PTH levels ...
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Introduction: The aim of this study was to determine the outcome of low PTH after surgery and to monitor parathyroid recovery times in patients who underwent total thyroidectomy. Material and Methods: A commercially available PTH (iPTH) test was used to monitor iPTH levels on days 1 and 4. PTH levels were negative. It is determined by the same blood test as the sCa level. To exclude vitamin D deficiency, we first measured 25-hydroxyvitamin D and 1,25-dihydroxyvitamin D levels in all patients Postoperative hypoparathyroidism was defined as postoperative albumin-adjusted sCa levels below 1.9 mmol/L (Convert to mg/dL, divide) with 0.25 (range of use, 2.10-2.60 mmol/L) symptoms of hypocalcemia (response to neuromuscular stress including paresthesias, muscle spasms, tetany or seizures) or sCa levels lower than results (1.9-2.1 mmol/L) with neuromuscular symptoms during the first 4 days after surgery. Results: In a multivariate logistic regression model, we found that patients who received an autograft of parathyroid tissue during surgery were more likely to have low PTH immediately after surgery (OR = 2.6; 95% CI, 1.8-3.8). Additionally, patients with parathyroid tissue who showed negative parathyroid tissue removal on the final pathology report were more likely to have postoperative PTH <10 pg/mL (OR = 2.2; 95% CI, 1.5 -3.3). Parathyroid tissue was the only risk factor for permanent hypoparathyroidism in the pathology report (OR = 3.6, 95% CI, 1.1–11.5). Conclusion: This study suggests that drug therapy should be considered in addition to PTH measurement, as 50% of patients with persistent hypoparathyroidism have elevated PTH levels to ≥10 pg/mL, but still want more help to avoid hypoparathyroidism. Symptoms of calcemia. In addition, 12 months may be the most appropriate time to define persistent hypoparathyroidism, as 5% of patients with low PTH resolve 6-12 months after treatment.
Medicine
Abdolreza Mehdinavaz Aghdam; Fariborz Rousta
Abstract
Introduction: NSAIDs are widely used in the treatment of back pain as they avoid most of the side effects of opioids such as respiratory depression, sedation, hallucinations, euphoria, addiction, shortening of bowel movements, periods and constipation. They are mostly used for mild to moderate pain where ...
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Introduction: NSAIDs are widely used in the treatment of back pain as they avoid most of the side effects of opioids such as respiratory depression, sedation, hallucinations, euphoria, addiction, shortening of bowel movements, periods and constipation. They are mostly used for mild to moderate pain where patients can tolerate oral medications. Ketorolac trometamol is a parenteral NSAID, thus eliminating the need for patients to avoid entering the body, which is a problem immediately after abdominal surgery. Ketorolac inhibits prostaglandin synthesis by inhibiting the cyclooxygenase system. Material and Methods: At PACU, patients receive morphine at the discretion of the counseling program. All patients were given PCA morphine (1 mg bolus, 5 min lockout, 4-hour limit 30 mg) after discharge from the unit. Medicated analgesia is administered by the Pain Unit and stopped on the third postoperative day if the patient is urinating, has used less than 30 mg of morphine in the last 12 hours, and has less than 4/10 pain. During this time, all patients received 500 mg of BID oral naproxen supplemented with 1000 mg of oral acetaminophen every 6 hours.Results: The ketorolac group held this drug until day 6, when all eight patients were hospitalized. Two patients in the ketorolac group developed anastomotic leakage early after surgery and their care was excluded from further analysis due to significant differences in the study. The first leak occurred 4 days later in a 37-year-old man who had undergone a sigmoidectomy for diverticulitis with peritonitis. Conclusion: The main effect of short hospital stay is uncertain, possibly due to insufficient power for early decision making. Anastomotic leakage rate was higher than normal, especially in the ketorolac group, but there is no example of this in other studies and we can only evaluate it as negative.
Medicine
Abdolreza Mehdinavaz Aghdam; Fariborz Rousta
Abstract
Introduction: The objective of the study was to assess and compare the analgesic effectiveness and safety profiles of pethidine in relieving pain experienced post major surgical procedures. Material And Methods: A prospective interventional investigation was carried out on a cohort of 71 patients who ...
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Introduction: The objective of the study was to assess and compare the analgesic effectiveness and safety profiles of pethidine in relieving pain experienced post major surgical procedures. Material And Methods: A prospective interventional investigation was carried out on a cohort of 71 patients who underwent a significant surgical procedure. In this study, a total of 71 patients were administered intramuscular medication for a duration of 48 hours following surgery. Specifically, 36 individuals were treated with placebo dosages of 3 CC administered at 6-hour intervals, whereas the remaining 35 received 100 mg doses of pethidine at the same frequency. The present study aimed to evaluate and compare the analgesic efficiency and safety of placebo and pethidine. The aforementioned evaluation was performed at various time intervals of 1, 6, 12-, 24-, 32-, and 48-hours post-administration of the respective drugs. The efficacy of analgesics was evaluated through the utilization of both the Visual Analogue Scale (VAS) and Verbal Rating Scale (VRS). Results: The present study demonstrated the equianalgesic efficacy between placebo and Pethidine as determined by both Visual Analogue Scale (VAS) scores at 12 and 48 hours, and Verbal Rating Scale (VRS) scores at 1 and 48 hours during the postoperative period. During alternative observation periods, it was observed that pethidine demonstrated superior analgesic properties when compared to ketorolac. Conclusion: Pethidine demonstrated a higher degree of efficacy as an analgesic agent in comparison to ketorolac. Additional investigations, comprising a double-blind randomized trial, have been proposed to authenticate the findings presented in the current undertaking.
