Medicine
Parham Maroufi; Mahdi Nazari
Abstract
Introduction: This systematic review aims to evaluate the analgesic effect of intravenous dexamethasone in patients undergoing volar plate surgery for distal radius fractures. The findings of this review will provide valuable insights into the potential role of dexamethasone as an adjunctive analgesic ...
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Introduction: This systematic review aims to evaluate the analgesic effect of intravenous dexamethasone in patients undergoing volar plate surgery for distal radius fractures. The findings of this review will provide valuable insights into the potential role of dexamethasone as an adjunctive analgesic agent in this surgical setting. By synthesizing the available evidence, this review aims to contribute to the existing literature and guide clinical decision-making regarding postoperative pain management strategies. Material and Methods: Data extraction was performed independently by two reviewers using a standardized data extraction form. The following information was collected: study characteristics (author, year of publication, study design), patient demographics (sample size, age, sex), surgical details (type of volar plate surgery, anesthesia technique), intervention details (dose, timing, and duration of intravenous dexamethasone administration), control group characteristics, outcome measures, and relevant results. Any discrepancies were resolved through discussion and consensus. Results: The primary outcome measure assessed in the included studies was postoperative pain intensity. Pain intensity scores were evaluated using various validated pain rating scales, including the visual analog scale (VAS) and numerical rating scale (NRS). Secondary outcome measures included postoperative opioid consumption, time to first analgesic request, duration of analgesic effect, adverse effects related to dexamethasone administration, and patient satisfaction scores. Conclusion: this systematic review provides evidence supporting the analgesic effect of intravenous dexamethasone following volar plate surgery for distal radius fractures. Dexamethasone effectively reduces postoperative pain intensity, opioid consumption, and the need for rescue analgesia. The sustained analgesic effect and favorable safety profile make dexamethasone a promising adjunctive analgesic in this surgical setting.
Medicine
Ali Sharifi; Abbasali Dehghani
Abstract
Introduction: Gastrectomy plays a central role in the management of gastric cancer, and its short-term outcomes have significant implications for patient care and treatment decisions. Surgical morbidity, postoperative recovery, length of hospital stays, and the impact of minimally invasive techniques ...
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Introduction: Gastrectomy plays a central role in the management of gastric cancer, and its short-term outcomes have significant implications for patient care and treatment decisions. Surgical morbidity, postoperative recovery, length of hospital stays, and the impact of minimally invasive techniques and lymph node dissection are all critical factors to consider.Material and Methods: This study aimed to investigate the short-term outcomes of gastrectomy for patients with gastric cancer. A retrospective cohort study design was employed to analyze data from a single-center database. The study period spanned from 2019 to 2020.Results: Subgroup analyses were conducted to identify factors associated with surgical morbidity. Multivariable logistic regression analysis revealed that advanced tumor stage (2.25 95% CI, 2.11-3.19), open surgical approach (5.51 95% CI: 4.88-7.19), and a higher Clavien-Dindo classification (5.595% CI: 5-12.3) were independent predictors of surgical morbidity. These findings highlight the importance of early detection and management of complications, as well as the potential benefits of minimally invasive techniques in reducing surgical morbidity (fig 3).Conclusion: In conclusion, the study on short-term outcomes of gastrectomy in patients with gastric cancer provides valuable insights into the potential risks and benefits associated with the surgical procedure. It emphasizes the need for careful patient selection, meticulous surgical techniques, and comprehensive postoperative care to optimize outcomes and enhance patient satisfaction. Further research is warranted to explore long-term oncological outcomes and survival to provide a more comprehensive understanding of the overall impact of gastrectomy in the treatment of gastric cancer.
Medicine
Mohammad Reza Moharrami; Mahdi Nazari
Abstract
Introduction: This systematic review aims to compare the efficacy and safety of low-dose intravenous ketamine-midazolam with intravenous morphine for pain control in patients with hand fractures. By synthesizing the available evidence, we seek to provide clinicians with valuable insights into the potential ...
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Introduction: This systematic review aims to compare the efficacy and safety of low-dose intravenous ketamine-midazolam with intravenous morphine for pain control in patients with hand fractures. By synthesizing the available evidence, we seek to provide clinicians with valuable insights into the potential benefits and limitations of these analgesic strategies, aiding in informed decision-making for optimal pain management in this patient population. Material and Methods: This systematic review follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines to ensure transparency and methodological rigor in the review process. Results: The primary outcome of pain control was assessed using various pain scales, including the Visual Analog Scale (VAS) and Numeric Rating Scale (NRS). The majority of studies reported comparable pain control between low-dose ketamine-midazolam and intravenous morphine. Both analgesic regimens resulted in significant pain reduction. A subset of studies demonstrated that low-dose ketamine-midazolam provided superior pain control compared to intravenous morphine, particularly in the immediate post-intervention period. However, the overall evidence regarding the superiority of one regimen over the other was inconclusive due to variations in study designs, sample sizes, and outcome measures. Conclusion: Low-dose intravenous ketamine-midazolam and intravenous morphine are both effective analgesic regimens for pain control in patients with hand fractures. While the evidence regarding the superiority of one regimen over the other remains inconclusive, low-dose ketamine-midazolam appears to offer comparable pain control with reduced opioid consumption anda favorable safety profile.
Medicine
Saeid Charsouei; Mohsen Mohammadrahimi
Abstract
Introduction: Neuropathic post-surgical pain (NPSP) is a debilitating condition that can occur following surgical procedures, including radical prostatectomy. Preoperative pain has emerged as a potential risk factor for the development of NPSP, suggesting that early identification and management of preoperative ...
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Introduction: Neuropathic post-surgical pain (NPSP) is a debilitating condition that can occur following surgical procedures, including radical prostatectomy. Preoperative pain has emerged as a potential risk factor for the development of NPSP, suggesting that early identification and management of preoperative pain may play a crucial role in preventing NPSP. This study aimed to investigate the association between preoperative pain and NPSP following radical prostatectomy, providing valuable insights into the pathophysiology and prevention of NPSP. Material and Methods: Following surgery, participants were followed up for a period of six months to assess the development of NPSP. Postoperative pain assessments were conducted at regular intervals, including one week, one month, three months, and six months after surgery. Pain intensity was evaluated using the NRS, and pain characteristics were assessed using validated neuropathic pain assessment tools, such as the Leeds Assessment of Neuropathic Symptoms and Signs (LANSS) and the Douleur Neuropathique 4 Questions (DN4) questionnaire. Results: Functional impairment and quality of life were also significantly affected in patients with NPSP. The BPI interference scores, which measure the impact of pain on daily activities, were significantly higher in the NPSP group compared to the non-NPSP group at all follow-up time points (p < 0.001). Similarly, the EuroQol-5D questionnaire, which assesses health-related quality of life, revealed lower scores in the NPSP group, indicating poorer overall well-being (p < 0.001). Conclusion: this study highlights the significance of preoperative pain as a risk factor for the development of NPSP following radical prostatectomy. Patients with preoperative pain are at a significantly higher risk of experiencing NPSP, which is associated with higher pain intensity, functional impairment, and decreased quality of life. Efforts should be made to implement preoperative pain assessment protocols and optimize pain management strategies to minimize the risk of NPSP and improve postoperative outcomes.
Medicine
Ali Sharifi; Fariborz Rousta
Abstract
Introduction: Post-thyroidectomy hypocalcemia is a significant complication that can occur following thyroid surgery. Patient-related factors, surgical factors, and pathological factors contribute to the development of hypocalcemia. Prompt recognition, appropriate management, and preventive measures ...
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Introduction: Post-thyroidectomy hypocalcemia is a significant complication that can occur following thyroid surgery. Patient-related factors, surgical factors, and pathological factors contribute to the development of hypocalcemia. Prompt recognition, appropriate management, and preventive measures are essential to minimize the occurrence of hypocalcemia and its associated complications.Material and Methods: This article aimed to investigate the risk factors associated with post-thyroidectomy hypocalcemia. A retrospective cohort study design was employed to analyze data from patients who underwent thyroidectomy at a single institution. The study period spanned from January 2018 to December 2020. The study protocol was approved by the Institutional Review Board (IRB) of the institution.Results: In the univariate logistic regression analysis, several risk factors were significantly associated with an increased risk of post-thyroidectomy hypocalcemia. Advanced age was found to be a significant predictor, with patients aged 60 years or older having a higher risk compared to younger individuals (OR 2.4, 95% CI 1.5-3.8, p<0.001). Female gender was also associated with an increased risk of hypocalcemia (OR 1.8, 95% CI 1.2-2.7, p=0.005)Conclusion: this study identified several risk factors associated with post-thyroidectomy hypocalcemia, including advanced age, female gender, lower preoperative calcium levels, total thyroidectomy, presence of thyroid cancer, and extensive thyroid gland involvement. These findings can aid in preoperative risk stratification, surgical planning, and patient counseling.
Medicine
Ali Sharifi; Abbasali Dehghani
Abstract
Introduction: The outcomes after esophagectomy have transformed the management of esophageal pathologies. esophagectomy has revolutionized the field of esophageal surgery by providing patients with less postoperative pain, reduced complications, faster recovery, and improved functional and oncological ...
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Introduction: The outcomes after esophagectomy have transformed the management of esophageal pathologies. esophagectomy has revolutionized the field of esophageal surgery by providing patients with less postoperative pain, reduced complications, faster recovery, and improved functional and oncological outcomes. As surgical techniques continue to evolve, esophagectomy represents a paradigm shift in the approach to esophageal surgery, paving the way for future advancements and improved patient care.Material and Methods: This article utilizes a retrospective study design to assess the outcomes after esophagectomy. The study involved analyzing medical records and data from patients who underwent esophagectomy at a single institution between a specified period. The study aimed to evaluate various outcome measures, including postoperative pain, complications, length of hospital stay, pulmonary function, gastrointestinal complications, and oncological outcomes.Results: The outcomes after esophagectomy demonstrated several favorable results compared to traditional open esophagectomy. Postoperative pain scores were significantly lower in the esophagectomy group, with a mean visual analog scale (VAS) score of 3.5 (range: 1-7) compared to 6.8 (range: 4-9) in the open surgery group (p < 0.001). This reduction in pain allowed for earlier initiation of oral intake, with a median time to resumption of oral intake of 3 days in the esophagectomy group compared to 7 days in the open surgery group (p < 0.001).Conclusion: In conclusion, this study highlights the favorable outcomes after esophagectomy and emphasizes its potential as a pioneering surgical technique in the field of esophageal surgery. esophagectomy offers several advantages over traditional open surgery, including reduced postoperative pain, shorter hospital stays, improved pulmonary function, and decreased rates of gastrointestinal complications.
Medicine
Sanaz Yasrebinia; Mansour Rezaei
Abstract
Introduction: This study aiming to provide vital insights into the potential impacts of these treatment modalities (morphine or methadone) on the neurodevelopmental trajectories of Neonatal Abstinence Syndrome (NAS) -affected infants. By investigating the potential disparities in neurodevelopmental outcomes ...
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Introduction: This study aiming to provide vital insights into the potential impacts of these treatment modalities (morphine or methadone) on the neurodevelopmental trajectories of Neonatal Abstinence Syndrome (NAS) -affected infants. By investigating the potential disparities in neurodevelopmental outcomes associated with morphine and methadone, we aspire to inform evidence-based treatment decisions and refine the standard of care for NAS.Material and Methods: Eight participating locations included 116 full-term newborns diagnosed with NAS, born to mothers under methadone or buprenorphine maintenance, who were enrolled in a randomized trial comparing morphine to methadone. Upon hospital discharge, 99 of these infants (representing 85% of the cohort) underwent assessment using the NICU Network Neurobehavioral Scale (NNNS). At the 18-month mark, 83 out of the 99 infants (approximately 83.8%) underwent evaluation employing the Bayley Scales of Infant and Toddler Development-Third Edition (Bayley-III), while the Child Behavior Checklist (CBCL) was administered to 77 of the 99 infants (around 77.7%).Results: Our adjusted analyses further revealed that internalizing and total behavior problems were linked to the utilization of phenobarbital (p=0.03 and p=0.04, respectively), elevated levels of maternal psychological distress (as measured by the Brief Symptom Inventory) (both p<0.01), and the presence of infant medical issues (both p=0.02). Additionally, externalizing problems were associated with maternal psychological distress (p<0.01) and continued maternal substance use (p<0.01).Conclusion: Neonates administered either morphine or methadone exhibited comparable neurobehavioral outcomes in both the short and long term. The neurodevelopmental progress of these infants may be associated with factors such as the requirement for phenobarbital, the general health of the infant, and the quality of postnatal caregiving.
Medicine
Sanaz Yasrebinia; Mansour Rezaei
Abstract
Introduction: As the global community strives to ensure the health and well-being of mothers and newborns, AI emerges as a powerful ally in this noble endeavor. Through this systematic review, we seek to provide a comprehensive overview of the state of AI-driven mortality prediction, offering insights ...
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Introduction: As the global community strives to ensure the health and well-being of mothers and newborns, AI emerges as a powerful ally in this noble endeavor. Through this systematic review, we seek to provide a comprehensive overview of the state of AI-driven mortality prediction, offering insights that may shape the future of maternal and neonatal healthcare and bring us closer to the goal of ensuring safe pregnancies and healthy beginnings for all. Material and methods: We systematically reviewed the literature, restricting our search to publications from the past decade, and utilized the five major scientific databases as primary sources. Results: Out of the initial pool of 671 works, a total of 18 primary studies were meticulously chosen for in-depth analysis. It was evident that a predominant focus of these studies revolved around the prediction of neonatal mortality, predominantly employing machine learning models, with Random Forest being a popular choice. The top five frequently utilized features for model training encompassed birth weight, gestational age, the child's gender, Apgar score, and the mother's age. The development of predictive models for mitigating mortality during and after pregnancy holds immense potential, not only for enhancing the quality of life for mothers but also as a potent and cost-effective tool for reducing mortality rates. Conclusion: Drawing from the findings of this systematic review, it becomes evident that substantial scientific endeavors have been undertaken in this domain. However, it is equally apparent that numerous unexplored research avenues and opportunities await further exploration within the research community.
Medicine
Ali Sharifi; Zhale Bakhtiari
Abstract
Introduction: A comprehensive understanding of these complications, their risk factors, and appropriate management strategies is essential for surgeons and healthcare providers involved in the care of patients undergoing pancreaticoduodenectomy. Continued research, advancements in surgical techniques, ...
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Introduction: A comprehensive understanding of these complications, their risk factors, and appropriate management strategies is essential for surgeons and healthcare providers involved in the care of patients undergoing pancreaticoduodenectomy. Continued research, advancements in surgical techniques, and multidisciplinary collaboration are needed to further improve outcomes and reduce the incidence of complications following this challenging surgical procedure.Material and Methods: This article was a retrospective observational study conducted to evaluate the incidence, clinical significance, and management of complications associated with pancreaticoduodenectomy. The study aimed to analyze a cohort of patients who underwent pancreaticoduodenectomy at a single institution over a specified period.Results: Several factors were found to be associated with the occurrence of complications following pancreaticoduodenectomy. Prolonged operative time (>6 hours) was significantly associated with an increased risk of pancreatic fistula (p=0.043) and postoperative hemorrhage (p=0.018). Intraoperative blood loss (>500 mL) was also associated with a higher incidence of postoperative hemorrhage (p=0.032). Patients with preoperative comorbidities, such as diabetes and cardiovascular disease, had a higher risk of developing postoperative infections (p=0.016 and p=0.023, respectively).Conclusion: Complications following pancreaticoduodenectomy remain a significant challenge despite advancements in surgical techniques and perioperative care. Pancreatic fistula, delayed gastric emptying, postoperative hemorrhage, and biliary complications are among the most common complications observed in this study.
Medicine
Mohsen Nabiuni; Jaber Hatam; Maryam Milanifard; Elham Seidkhani; Amin Jahanbakhshi
Abstract
Peripheral neuropathy is the result of damage to nerves outside the brain and spinal cord and often causes weakness, numbness and pain, usually in the hands and feet. It can also affect other parts and functions of the body such as digestion, urination and blood circulation. The peripheral nervous system ...
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Peripheral neuropathy is the result of damage to nerves outside the brain and spinal cord and often causes weakness, numbness and pain, usually in the hands and feet. It can also affect other parts and functions of the body such as digestion, urination and blood circulation. The peripheral nervous system is responsible for sending information from the brain and spinal cord to other parts of the body. Also, peripheral nerves send sensory information to the central nervous system. Peripheral neuropathy can be caused by severe injuries, infections, metabolic problems, hereditary causes, and exposure to toxic substances, one of the most common causes of which is diabetes. People with peripheral neuropathy usually experience throbbing, burning, or tingling pain, and in many cases, symptoms improve. Especially if the cause is a treatable problem. Medicine can also reduce the pain of peripheral neuropathy. There are different types of peripheral neuropathy caused by different causes. These cases range from carpal tunnel syndrome to nerve damage due to diabetes. All types of peripheral neuropathy as a group are especially common in people over 55 years of age. This condition affects 3-4% of people in this group. Neuropathies are usually categorized based on the problems they cause and their causes. There are also terms that indicate how severe the nerve damage is.
Medicine
Mahboubeh Pazoki; Pegah Joghataie; Omolbanin Asadi Ghadikolaei; Sina Shojaei; Marjan Hajahmadi; Mohsen Taghavi Shavazi
Abstract
Objective: Cardiac thromboses are not uncommon, but right atrial thromboses are extremely rare. Methods: This study is a systematic study. 1541 articles were analyzed based on keywords and according to pubmed, scopus, web of science and embase databases. After removing duplicates, 964 articles remained. ...
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Objective: Cardiac thromboses are not uncommon, but right atrial thromboses are extremely rare. Methods: This study is a systematic study. 1541 articles were analyzed based on keywords and according to pubmed, scopus, web of science and embase databases. After removing duplicates, 964 articles remained. Finally, after reviewing the articles according to the title and abstract, 906 articles were removed and only 58 articles were included in the study and analyzed. Results: After the investigations, the results showed that in the studies, surgical treatments and anticoagulation and thrombolysis treatments were used to treat patients. Discussion: Finally, according to the data obtained from this study, it has been shown that the use of anticoagulation and thrombolysis treatment methods compared to surgical treatment for the treatment of patients can be associated with fewer complications for them. The use of surgery as the first treatment option can be combined with the use of antibiotics to prevent infection in patients. Therefore, the type of treatment can be chosen based on the clinical process and clinical symptoms of the patients.
Medicine
Amir Abbas Esmaeilzadeh; Fatemeh Nasirzadeh
Abstract
The uterus is a hollow and pear-shaped organ in the pelvic area, located between the bladder and the rectum and covered by a tissue called the endometrium. The endometrium is made every month in the uterus, which is removed from the body during menstruation. Also, there are two tubes on both sides of ...
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The uterus is a hollow and pear-shaped organ in the pelvic area, located between the bladder and the rectum and covered by a tissue called the endometrium. The endometrium is made every month in the uterus, which is removed from the body during menstruation. Also, there are two tubes on both sides of the uterus, which are known as fallopian tubes. The task of these tubes is to release eggs and guide them into the uterus for fertilization. In the cervix, if there are abnormal cells that grow abnormally, uterine cancer occurs. This cancer can be treated if detected early. Ultrasound is one of the common methods for imaging the internal parts of the body. Among the applications of this treatment method, we can mention the diagnosis of uterine cancer. Cervical cancer is one of the most curable cancers. The necessary condition for the treatment of this cancer is to detect it on time and in the early stages. According to the report of the American Cancer Society, the higher the screening rate with pap smear tests, the lower the mortality from cervical cancer. Regular Pap smear tests are one of the most important and effective prevention methods to detect cells at risk of becoming cancerous. Getting the HPV vaccine and doing regular pap smear screenings can help you reduce the risk of cervical cancer.
Medicine
Hamid Owaysee Osquee; Sanaz Yasrebinia
Abstract
Introduction: One of the biggest challenges is to reduce inflammation without compromising the patient's proper immune response. In this hypothesis, science should focus on medicine and nutrition. The importance of proper nutritional status and eating habits has been widely recognized in the Covid-19 ...
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Introduction: One of the biggest challenges is to reduce inflammation without compromising the patient's proper immune response. In this hypothesis, science should focus on medicine and nutrition. The importance of proper nutritional status and eating habits has been widely recognized in the Covid-19 pandemic. Therefore, the present study answers the question of what is the role of nutrition on Covid-19 in pediatric. Methodology: The present study is a systematic review that was conducted during the third quarter of 2022 at Tabriz university of medical sciences. Therefore, at first the keywords were determined and then the search was performed among all Persian and English language databases. Results: The covid-19 epidemic has had a wide impact on the health, economy and livelihood of people in the past and has caused sudden changes in the way of life of people through social distance and quarantine at home with irreparable mental consequences. Optimizing public health during this epidemic requires not only the knowledge of medical and biological sciences, but also all sciences related to lifestyle, social and behavioral studies, including food habits and lifestyle. Conclusion: Changing the eating style and choosing a healthy diet rich in nutrients can lead to strengthening the immune system and overcoming diseases, including corona disease.
Medicine
Hamzeh Hosseinzadeh; Parichehr Mazuji; Samad Eslam Jamal Golzari
Abstract
Introduction: Ephedrine and phenylephrine are the preferred vasopressors for preventing SAIH in the elderly. Our study's goal was to assess how well prophylactic intravenous (IV) ephedrine or N/S infusions prevented hypotension and decreased CO after SA in patients older than 60 undergoing elective orthopedic ...
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Introduction: Ephedrine and phenylephrine are the preferred vasopressors for preventing SAIH in the elderly. Our study's goal was to assess how well prophylactic intravenous (IV) ephedrine or N/S infusions prevented hypotension and decreased CO after SA in patients older than 60 undergoing elective orthopedic surgery. Material and Methods: The patients were randomly assigned to one of the three groups using sealed envelope randomization for the administration of the prescribed medication. Thirty milliliters of 0.9% NaCl were infused into the C group (control group) 30 minutes after SA. Thirty minutes after SA, the E group (ephedrine group) received a continuous infusion of 30 ml of 0.9% NaCl and 20 mg of ephedrine. Following SA, a volumetric IV pump was used to begin the infusion of the prescribed treatment medication in all groups. Using the AESCULON, OSYPCA MEDICAL, 2011, monitor, we measured non-invasive blood pressure, non-invasive CO using the thoracic electrical bioimpedance (TEB) method, heart rate, and pulse oximetry (SpO2). Results: A brief statistically significant decrease in MAP was observed in the P group 10 and 20 minutes after the block, but by the time the measurements were complete, MAP had nearly reached baseline levels. In the E group, MAP was preserved following SA. At the conclusion of the measurements, there were no differences between the P and E group, but the decrease in MAP was noticeably greater in the C group than the E and P group. In the C and P groups, CI after SA decreased non-significantly, while in the E group, CI significantly increased after SA. Conclusion: In conclusion, our research demonstrates that we can maintain MAP following SA by combining the Ringers solution infusion with an infusion of ephedrine or phenylephrine.
Medicine
Hamid Owaysee Osquee; Ali Reza Lotfi
Abstract
Examining laboratory parameters to determine acute or less severe cases of mucormycosis after contracting covid-19, identifying patients who are at higher risk of mortality, and increasing awareness for proper practice will be useful in improving the clinical situation. So we decided to Investigate Factors ...
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Examining laboratory parameters to determine acute or less severe cases of mucormycosis after contracting covid-19, identifying patients who are at higher risk of mortality, and increasing awareness for proper practice will be useful in improving the clinical situation. So we decided to Investigate Factors Affecting Mortality From mucormycosis After Covid-19 Infection. Methods: This study was a systematic review (Conducted by PRISMA guideline). This study was conducted in Tabriz university of medical sciences in 2022. Results: From examining the results of these studies (15 studies), it was found that mortality was higher in patients hospitalized in ICU and general wards, and a significant difference was observed between the average age of recovered and deceased patients. Having high blood pressure as well as diabetes mellitus also significantly led to an increase in mortality. Conclusion: Hospitalization in the intensive care unit, advanced age, high severity of covid-19, high blood sugar and underlying diseases significantly increase the risk of death due to mucormycosis following covid-19.
Medicine
Alfred Atlinkson
Abstract
To evaluate the work of the left ventricular muscle, aortic and mitral valves or open coronary arteries. This method is used to assess the patient's condition before and after heart surgery. In both left and right heart catheterization methods, there is a possibility of allergic reaction to the contrast ...
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To evaluate the work of the left ventricular muscle, aortic and mitral valves or open coronary arteries. This method is used to assess the patient's condition before and after heart surgery. In both left and right heart catheterization methods, there is a possibility of allergic reaction to the contrast agent in the form of nausea, vomiting, flushing, burning sensation, numbness, hives and itchy skin. Anaphylactic shock rarely occurs, so after the use of osmotic diuretics and hydration of the patient helps to expel the contrast agent faster. The patient should fast for 8-12 hours. Tell the client to lie on a firm bed for about 2 hours, give a sedative usually diazepam (5 to 10 mg) and diphenhydramine (25 to 50 mg), and stop taking anticoagulants such as warfarin 48 hours before. Work or only patient PT is 18 seconds. Explanation to the patient There is a strong desire to cough (catheterization of the heart) when the contrast agent is injected. Sudden onset of urination and urination, which resolves within a few minutes. Control vital signs of having an open and suitable vessel, measuring height and weight to calculate the appropriate amount of medication. Explain to the patient that he or she will sometimes feel a throbbing sensation in the chest. This palpitation is due to the extrasystoles that appear, especially when the tip of the catheter hits the ventricular wall. The patient is asked to cough or take deep breaths, especially after the contrast agent is injected. Coughing may interrupt the dysrhythmia and also help the contrast material to pass through the arteries.
Medicine
Alfred Atlinkson
Abstract
It is a surgical procedure in which blood vessels from another part of the body are blocked into an artery, thereby removing the blocked flow path and opening a bypass in the area of the coronary occlusion, and blood flowing down the stenosis with this graft again. Is established. That is why it is called ...
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It is a surgical procedure in which blood vessels from another part of the body are blocked into an artery, thereby removing the blocked flow path and opening a bypass in the area of the coronary occlusion, and blood flowing down the stenosis with this graft again. Is established. That is why it is called a bypass link. Several factors are involved in performing CABG. The number of coronary arteries involved, the degree of failure with left ventricular dysfunction, the presence of other health problems, the patient's symptoms, and the history of treatment. Patients who have drug-resistant unstable angina, chronic stable angina with acute complications that disrupt the patient's life, patients who have positive exercise test and radioisotope scan in addition to angina, patients who have obvious narrowing of the main coronary artery They have the left. Patients with all three major coronary arteries involved. The lower saphenous vein of the knee is mostly used because it is similar in diameter to the coronary arteries and is removed through a longitudinal incision in the inner surface of the leg and thigh and separating its branches. The vein is then examined for sclerosis.
Medicine
Naser Ghorbanian; Mahmood Eidi
Abstract
Introduction: Pharmacological interventions, such as gabapentin, have been utilized to alleviate the symptoms of CTS, but the optimal dosage remains uncertain. This article aims to review and compare the efficacy of two different doses of gabapentin, 100 mg and 300 mg, in the treatment of carpal tunnel ...
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Introduction: Pharmacological interventions, such as gabapentin, have been utilized to alleviate the symptoms of CTS, but the optimal dosage remains uncertain. This article aims to review and compare the efficacy of two different doses of gabapentin, 100 mg and 300 mg, in the treatment of carpal tunnel syndrome. The findings of this review may provide valuable insights for clinicians in selecting the appropriate dosage of gabapentin, balancing the need for pain relief with the potential for adverse effects.Methodology: Following surgery, patients were administered their assigned study medication (100 mg gabapentin, 300 mg gabapentin, or placebo) orally, 1 hour before the procedure. The study medication was prepared by a pharmacist who was not involved in data collection or analysis. Both the patients and the investigators assessing the outcomes were blinded to the treatment assignment.Results: Post hoc analyses using Tukey's test were conducted to assess specific between-group differences in pain scores. At 1 hour postoperative, there was no significant difference in pain scores between the three groups (p>0.05). However, starting from 2 hours postoperative and continuing at all subsequent time points, both the 100 mg and 300 mg gabapentin groups demonstrated significantly lower pain scores compared to the placebo group (p<0.001).Conclusion: The results of this study demonstrate that both 100 mg and 300 mg doses of gabapentin are effective in reducing postoperative pain following CTS surgery. The 300 mg dose exhibited superior analgesic efficacy compared to the 100 mg dose, as evidenced by significantly lower pain scores and reduced rescue analgesia consumption.
Medicine
Frank Ablin Derosow
Abstract
Cermet, an abbreviation used worldwide for a homogeneous mixture consisting of metals or alloys or one or more ceramic phases comprising approximately 15 to 18% by volume and relatively little solubility between the metal and ceramic phases at the preparation temperature. It is being used. A good definition ...
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Cermet, an abbreviation used worldwide for a homogeneous mixture consisting of metals or alloys or one or more ceramic phases comprising approximately 15 to 18% by volume and relatively little solubility between the metal and ceramic phases at the preparation temperature. It is being used. A good definition of the word ceramic can be found in "Ceramic index". Any unusual, non-metallic product that is exposed to high temperatures during manufacture or use. By way of example, but not exclusively, the ceramic is a metal oxide, braide, carbide, or combination or mixture of such materials; In which there are anions that play an important role in atomic structure and properties. With a specific source on cermet’s, this definition of a ceramic component can be expanded to include nitrides, carbonatites, and silicides. In a broad view, cermet’s are like a special type of hard and refractory materials in the general class of metal composites. This topic is well covered in scientific papers, especially in the spectrum of specific comparable fracture volumes and metallic components. Compared to composite layers, the combination of metal and non-metal in cermet’s occurs on a very small scale. The non-metallic phase is usually non-filamentous, but a number of fine non-coaxial grains are formed, which are well dispersed and attached to the metal matrix. If the metal or ceramic component is often in the form of filaments, the material should be considered as a composite material. The connection between the non-metallic phase and the metallic background creates important effects among cermet’s; This greatly affects the phase associations, solubility and wetting characteristics associated with ceramic and metal components.
Medicine
Martin Viberman
Abstract
The process of hot extrusion of very fine cemented carbide powder with a combination of softener has been known for many years. This method has been successfully used for cermet’s to make simple prismatic shapes that have a large length to cross-sectional area ratio. Cylindrical and quadrangular ...
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The process of hot extrusion of very fine cemented carbide powder with a combination of softener has been known for many years. This method has been successfully used for cermet’s to make simple prismatic shapes that have a large length to cross-sectional area ratio. Cylindrical and quadrangular shapes and other sections can be easily made with this method, even making pipes is also possible. Depending on the plasticizer used (for example, polystyrene with the addition of dimethyl and diphenyl ether), the extrusion process requires temperatures between 160 and 175 degrees Celsius (320- and 350-degrees Fahrenheit). The process of complete and slow sticking under vacuum before full sintering is necessary and even vital to avoid stretching (from casting defects, from sagging), breaking or very small porosity. Twisting of bodies produced by extrusion similar to what happens in the plastic industry is acceptable for this process. In order to produce a high-quality product, hot pressing is necessary.
Medicine
Frank Ablin Derosow
Abstract
A major improvement in the resistance to deformation in TiC cermet’s and at the same time as a reduction in brittleness is possible by changing the arrangement of the bonded alloy or the carbide phase or both. to give an example of an optimal adhesive composition is 22.5% nickel, 10% molybdenum, ...
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A major improvement in the resistance to deformation in TiC cermet’s and at the same time as a reduction in brittleness is possible by changing the arrangement of the bonded alloy or the carbide phase or both. to give an example of an optimal adhesive composition is 22.5% nickel, 10% molybdenum, and approximately 7% aluminum. Improvement of the compressive yield strength of the carbide phase is achieved by forming a solid solution of TiC with 10% by weight of Vc. The addition of approximately 10% by weight of TiM greatly increases the deformation resistance of cermet. It is believed that this increase is ultimately the result of two factors, the effect of re-purification of the grains and the hardening of the carbide phase in the solid solution. If the ratio of titanium nitride to titanium carbide increases, carbo-nitride undergoes changes in its structure, which under controlled conditions can greatly improve the strength and fracture toughness of cermet. In the early 1970s, it was discovered that in the ternary systems Ti-MO-C-N and Ti-W-C-N there is a miscible gap in complete solid solutions between MON, MOC, TiN, and TiC under controlled, single-phase process conditions. Homogeneous solid solution breaks spontaneously or immediately into two similar phases that have close network parameters, but have different chemical compositions.
Medicine
Martin Viberman
Abstract
In the general field of cemented carbides, cobalt-bonded tungsten carbide groups are the category that has undergone the most development over the past three decades. Arrangements, physical properties, manufacturing methods and application of this class of materials have been reviewed in the cemented ...
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In the general field of cemented carbides, cobalt-bonded tungsten carbide groups are the category that has undergone the most development over the past three decades. Arrangements, physical properties, manufacturing methods and application of this class of materials have been reviewed in the cemented carbides article in this issue. In many applications, tungsten carbide bonded to cobalt has certain disadvantages. The properties of titanium carbide bonded to steel can be compared to the same material for tungsten carbide bonded to cobalt as follows: Titanium carbides bonded to steel respond to heat treatment and when the joint is in an annealed condition, it can be machined with conventional machines. Carbide bonded to fully hardened steel can be heated to a variety of temperatures. Hence, it obtains more ductility than tungsten carbide bonded to cobalt. Cemented tungsten carbides are materials with high modulus. Carbides bonded to steel have a modulus that is not greater than that of steel. The coefficient of thermal expansion of steel-bonded carbides is closer to that of steel than to cemented tungsten carbides. Both tungsten carbide and carbide products can be soldered.
Medicine
Antonin Brklay
Abstract
Gray cast iron will be produced from the alloy of iron and carbon, which is about 2% more, or the cooling speed is low, or silicon, which causes the instability of cementite. Now, if the amount of carbon is less than 3.4%, low carbon gray cast iron is obtained, which is easier to cast than steels, which ...
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Gray cast iron will be produced from the alloy of iron and carbon, which is about 2% more, or the cooling speed is low, or silicon, which causes the instability of cementite. Now, if the amount of carbon is less than 3.4%, low carbon gray cast iron is obtained, which is easier to cast than steels, which may have pearlite and pearlite properties. In the first stages of cutting the sample from the main piece, you are aware of its clarity, softness and neatness, and after cutting, filing is also done easily. But sanding it because of its high level of softness would be a problem. The result is that this steel is hyperiotectoid and according to the internal structure, i.e. the background of ferrite and pearlite grains, we understand that it contains 0.4% carbon and 5% ferrite and 5% pearlite, so we conclude that the more pearlite in the metal structure, the higher the percentage. Carbon is also more and the lower the amount and percentage of carbon, the higher the amount of ferrite, and the darkness of the surface under the microscope is the reason for this claim. The presence of sheet graphite causes gray cast iron to have unique properties. including having good machinability in conditions where the degree of hardness is such that the resistance to wear is excellent. The ability to resist burning in the last stages of the loss of lubricants is good, as well as the unusual elastic property that makes it capable of vibration. Several different factors affect the germination and growth of graphite sheets so that these graphite sheets can appear in different shapes and forms.
Medicine
Reza Eghdam Zamiri; Abdolreza Mehdinavaz Aghdam
Abstract
Introduction: moking increases the risk of postoperative pulmonary complications in patients receiving general anesthesia. During laparoscopic surgeries, the effects of pneumoperitoneum and carbon dioxide (CO2) insufflation may amplify these. Our goal was to compare the metabolic and blood gas analysis ...
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Introduction: moking increases the risk of postoperative pulmonary complications in patients receiving general anesthesia. During laparoscopic surgeries, the effects of pneumoperitoneum and carbon dioxide (CO2) insufflation may amplify these. Our goal was to compare the metabolic and blood gas analysis of patients who underwent laparoscopic surgeries while under general anesthesia compared to those who did not smoke.Material and Methods: After receiving approval from the institutional review board, the 60 patients undergoing laparoscopic cholecystectomy were split into two groups of 30 each: smokers and non-smokers. A arterial blood gas sampling was performed along with baseline hemodynamic parameters to evaluate and compare PCO2, pH, and bicarbonate (HCO3) values at different time intervals with respect to pneumo-peritoneum creation, between smokers and non-smokers.Results: Systolic blood pressure was higher at baseline in the smoker group, and oxygen saturation was noticeably lower. Smokers had significantly higher PCO2 and end-tidal CO2 at all timesConclusion: Between smokers and non-smokers, there is a clear distinction in baseline arterial blood gas characteristics. Smokers appear to be more susceptible to the metabolic effects of CO2 insufflation and elevated intraabdominal pressure.
Medicine
Mehrdad Zamani Esfahlani; Saeid Charsouei
Abstract
Introduction: Surface electromyography (sEMG) changes as a result of traumatic spinal cord injury (SCI), which disrupts spinal and supraspinal pathways. The sEMG is a useful addition to current clinical testing and can capture the residual motor command in great detail, even in muscles below the level ...
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Introduction: Surface electromyography (sEMG) changes as a result of traumatic spinal cord injury (SCI), which disrupts spinal and supraspinal pathways. The sEMG is a useful addition to current clinical testing and can capture the residual motor command in great detail, even in muscles below the level of injury with seemingly absent motor activities. We aimed to explain how the sEMG properties are altered after SCI in this in-depth review.Material and Methods: Following a thorough review of the literature, we focused on sEMG analysis methods and signal characteristics post-SCI. Early reports, according to what we discovered, tended to be primarily concerned with the qualitative analysis of sEMG patterns before moving on to semi-quantitative scores and a more thorough amplitude-based quantification.Results: On the other hand, recent studies are still limited to an amplitude-based analysis of the sEMG, and there are opportunities to more thoroughly characterize the time- and frequency-domain properties of the signal as well as to fully utilize high-density EMG techniques. We advise incorporating a wider variety of signal properties into the neurophysiological evaluation following SCI and gaining a better understanding of the relationship between these sEMG properties and underlying physiology.Conclusion: Improved sEMG analysis may help in understanding the mechanisms of change after neuromodulation or exercise therapy, as well as provide a more thorough description of how SCI affects upper and lower motor neuron function and their interactions.
