Medicine
Moen Hosein Pour Feyzi; Majid Montazer Bavil Olyaee
Abstract
Introduction: The symptoms of anastomotic leak often appear only at a late stage or are nonspecific, with many different diagnoses and treatments available with no clear consensus on the underlying mechanisms. The purpose of this review is to provide a brief summary of the existing literature on the ...
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Introduction: The symptoms of anastomotic leak often appear only at a late stage or are nonspecific, with many different diagnoses and treatments available with no clear consensus on the underlying mechanisms. The purpose of this review is to provide a brief summary of the existing literature on the definition and classification of thoracic esophagectomy anastomotic leak, its importance and prevalence, as well as the different risk factors, diagnoses and treatments.Material and Methods: Scopus and PubMed electronic databases were searched to identify articles published between 1995 and 2022 on AL after esophagectomy. Terms used include: “anastomotic leak,” “esophageal cancer,” “cervical,” “intrathoracic,” “diagnosis,” “management,” “risk factor,” combined with Boolean “OR” function study Frequent references for further research and related publications are searched. There is limited English language.Results: Anastomotic leak is one of the most common complications after esophagectomy and is associated with increased morbidity and mortality. Many projects range from small studies to large collaborations aimed at identifying potential preoperative and perioperative risks and improving diagnostic and management procedures. Despite the increase in available data, many aspects of anastomotic leak remain problematic and no general guidelines exist. Conclusion: AL after esophagectomy has many causes, is complex, and can have serious complications that will later affect the outcome. Current treatment is based on an individualized approach and reliable international evidence will help improve the prevention and treatment of AL. Treatment and patient outcomes. Higher quality evidence for such guidelines is urgently needed. The introduction of the ECCG system is a first priority to provide an up-to-date international standard for comparing the results of treatment strategies.
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
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.
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.
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.
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).
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.
Medicine
Alfred Atlinkson
Abstract
When a coronary artery narrows or closes, the area of the heart through which the artery is lubricated becomes ischemic and damaged, and a heart attack may occur. Oxygen is directly related to heart activity. The more active the heart, the greater the need for oxygen, and the coronary artery blood flow ...
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When a coronary artery narrows or closes, the area of the heart through which the artery is lubricated becomes ischemic and damaged, and a heart attack may occur. Oxygen is directly related to heart activity. The more active the heart, the greater the need for oxygen, and the coronary artery blood flow is adjusted according to the heart muscle's need for oxygen. The heart muscle consumes about 65% of the oxygen in the coronary artery, while other tissues in the body consume a maximum of 25% of the oxygen in the blood of the coronary artery. Also, unlike other tissues in the body, 75% of the heart muscle blood is supplied at rest by diastole of the heart. The coronary arteries are responsible for supplying blood to the heart muscle. The right and left coronary arteries branch from the aorta just above the aortic valve, then enter the heart and supply blood to the capillaries of the heart muscle. The two grooves meet at the posterior region of the heart in a place called the CRUX, where the AV group is located. If the RCA supplies blood to the cortex, these people are called the dominant right. The descending RCA branch intoxicates the left posterior muscle. Approximately 18% of people with CCA and RCA donate blood to the heart crocus, in which case it is called a balanced arterial pattern.
Medicine
Salar Javanmard Barbin; Negar Javanmard Barbin; Arash Dastshosteh; Mohammad Mahdi Nemati; Shiva Heidari
Abstract
The relationship between awareness and physical and mental health of people is direct and strong and is significant at the 95% confidence level. Since the Covid-19 disease is more effective on people with underlying diseases, therefore, if a person suffers from a chronic disease, it can make him sicker ...
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The relationship between awareness and physical and mental health of people is direct and strong and is significant at the 95% confidence level. Since the Covid-19 disease is more effective on people with underlying diseases, therefore, if a person suffers from a chronic disease, it can make him sicker and therefore the person has less desire to get information about this disease, which reduces the level of awareness. and this issue is also true in relation to intellectual obsessions. In such a way that students with phobia or any other mental disorder deal with the subject more carefully. On the other hand, high awareness in people reduces the amount of stress related to the disease and improves the level of mental health and subsequently physical health. The results of this research also showed that the relationship between attitude and physical and mental health of people is direct but relatively weak, although it is significant at the 95% confidence level. Although mental and physical health increases the level of awareness, it does not have an effect on a person's perspective of an existing reality.
Medicine
Negar Javanmard Barbin; Khosrow Hazrati Tappeh; Kambiz Diba; Khadijeh Makhdoumi; Masoumeh Rabieipour; Mahdia Gholamnejhad
Abstract
Fungal infections of respiratory system are the most common reason of death among immunosuppressed patients. Pulmonary candidiasis occurs as a primary bronchopneumonia or secondary type through blood diffusion. Primary bronchopneumonia of Candida, can also occur in patients which had been severely weakened ...
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Fungal infections of respiratory system are the most common reason of death among immunosuppressed patients. Pulmonary candidiasis occurs as a primary bronchopneumonia or secondary type through blood diffusion. Primary bronchopneumonia of Candida, can also occur in patients which had been severely weakened due to tumors, neutropenic patients receiving extensive chemotherapy and infants with very low weight. Aspiration of infectious oral discharges in bronchi and their expansion in pulmonary parenchyma is the main pathway of transmission in Candida bronchopneumonia. In the current research, the most common fungi isolated from respiratory systems were Candida species (91.9%). We certified strains from 38 yeast species, which included almost all medically important yeasts, were cultured on the chromogenic medium and resulting colorful colonies were evaluated. The morphologies of the colonies on cornmeal agar considered as a primary guide for our identifications so then, four Candida species plus C. neopforman as shown at table 2 are the probable alternatives diagnosed in cases suspected to PJP. The results obtained in this work for yeast abundance complied with the findings of other researchers around the world, and indicated that there were almost similar patterns for yeast outbreak in different populations.
Medicine
Bahare Mohabi Nuruddin Vand; Nastern Mousavi Bladi
Abstract
The academic period can be a stressful period due to the presence of many factors. In other words, it is a critical stage in the life of teenagers in every country and it is often associated with major changes in a person's life, especially in their social and human relationships. Being in such conditions ...
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The academic period can be a stressful period due to the presence of many factors. In other words, it is a critical stage in the life of teenagers in every country and it is often associated with major changes in a person's life, especially in their social and human relationships. Being in such conditions is often combined with the pressures, worries and excitements of this period, it affects the performance and efficiency of people and finally, their mental health. On the other hand, freshness and vitality, the academic progress of girls and boys in elementary school is due to their mental health. Mental disorders have existed since the beginning of mankind, and no one is immune to them, and it is a danger that constantly threatens mankind. During the 20th century, human life has been transformed and changed more than in the entire history. The great effort for industrialization, expansion of urban life and machine life has had negative effects on people's health and has created new issues about health and disease, social, economic, political, cultural disorder and environmental, social and psychological problems. It has caused many pathological reactions. Mental health, in preventive psychology, social mental health or social psychiatry refers to all methods and measures that are used to prevent and treat mental illnesses and to rehabilitate existing mental patients. Behavioral disorders are a group of behaviors by which the patient repeatedly violates the fundamental rights of others or violates social rules. This disorder develops in childhood or adolescence and is more common in boys than girls. Behavioral disorders have relatively the same prevalence in different societies. Many children who have behavioral disorders, when they reach adulthood, their disorder is largely or completely resolved.
Medicine
Roksana Babazadehkhoushrodi; Mohammadreza Babazadehkhoushroudi
Abstract
Introduction & Aim: The problem of crack formation during apical cavity preparation is one of the current challenges of endodontic problems. The purpose of this study was to investigate in vitro evaluation of effect of supporting bone on preventing cracks in roots resected by ultrasonic and bur.Materials ...
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Introduction & Aim: The problem of crack formation during apical cavity preparation is one of the current challenges of endodontic problems. The purpose of this study was to investigate in vitro evaluation of effect of supporting bone on preventing cracks in roots resected by ultrasonic and bur.Materials and Methods: In this experimental study, 113 single-rooted human teeth with single canal and direct root were examined in the control group (40 teeth) and the experimental group (73 teeth). To evaluate the number of canals and the curvature of the root, P.A digital radiographs were prepared from buccolingual and mesiodistal directions. All teeth were evaluated for surgical microscopy in terms of crack, external analysis, and any defect. In all samples, the apical cavity was provided with diamond burs and a spray of air and then irrigated with sodium hypochlorite. In the control and experimental group, the samples were divided into two groups with of supporting bone and no of supporting bone. Each group was again divided into two subgroups (A, B). Then from the 3 mm apical portion of the roots, it was cut off by bur (subgroup A) and ultrasonic (subgroup B). The cut surface was examined by endoscopy microscope for presence or absence of crack.Results: All samples with supporting bone in both groups were free from cracks by ultrasonic and bur. In endodontic roots, without supporting bone, 92.86% in bur method and 90% in the ultrasonic technique, lacked cracks. In the control group, without bone support, 20% in the bur method and all the samples in the ultrasonically free of cracks.Conclusion: Supporting bone prevents cracking in endodontic roots by ultrasonic and bur.
Medicine
Khosro Kolahdouzan; Behrooz Nazari
Abstract
Objective: Postoperative chronic pain (CPSP) is a common complication in musculoskeletal surgery. Physiotherapists usually treat patients with pain complaints before and after musculoskeletal surgery. The purpose of this article is (1) to identify the nature, process and importance of CPSPs; (2) expresses ...
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Objective: Postoperative chronic pain (CPSP) is a common complication in musculoskeletal surgery. Physiotherapists usually treat patients with pain complaints before and after musculoskeletal surgery. The purpose of this article is (1) to identify the nature, process and importance of CPSPs; (2) expresses the need to understand and solve the group's difficulties. We use a full collaborative transformation model to analyze pain processes and pain management strategies. Method and materials: This study is a systematic review. Results: Physicians who understand how inflammation alters the function of the immune system can select pain targets for their patients. Clinicians should not assume that patients on multidrug therapy have a medical problem. Instead, the current approach is to manage pain using preventive strategies to reduce the severity of postoperative pain and minimize the development of CPSP. Conclusion: The role of biological, surgical, psychological, and patient factors in the transition to chronic pain requires further research to better understand their relationship to pain. Serious illness and drug use. Appropriate assessment and management of risk factors for CPSP requires a team discussion to describe the patient's experience of postoperative pain and to assess the pain that occurs during surgery.
Medicine
Marjan Dehdilan; Khosrow Hashemzadeh
Abstract
Introduction: Postoperative onset atrial fibrillation (POAF) is a common complication of coronary artery bypass surgery (CABG). However, the long-term risk of thromboembolism in patients who develop POAF after CABG surgery is unknown. Also, there is no information about stroke prevention in this setting. ...
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Introduction: Postoperative onset atrial fibrillation (POAF) is a common complication of coronary artery bypass surgery (CABG). However, the long-term risk of thromboembolism in patients who develop POAF after CABG surgery is unknown. Also, there is no information about stroke prevention in this setting. To investigate the long-term risk of stroke and thromboembolism in patients with new-onset POAF after initial CABG alone compared with patients with non-functional non-valvular atrial fibrillation (NVAF)Material and Methods: This study used data from the Clinical Cardiac Surgery Database and the Danish National Registry to identify patients undergoing a primary CABG procedure and de novo CABG between January 1, 2000 and June 30, 2015. The age, sex, CHA2DS2-VASc score and year of diagnosis of these patients were compared with dysfunctional NVAF between 1 and 4. Data analysis was performed between 2012-15. Proportion of patients starting oral anticoagulation within 30 days and thromboembolic rate.Results: 115 patients who developed POAF after CABG surgery and 115 patients who developed NVAF were compared. In the total population of 10,540 patients, the median (interquartile range) age was 69 years.2 (63.7-74.7) years; 8675 patients (82.3%) were male. 175 POAF patients (8.4% and 3549 patients with NVAF (42.9%). The risk of thromboembolism was lower in the POAF group than in the NVAF group (18.3 vs. 29.7 events per 1000 person-years; adjusted hazard ratio [HR], 0.55; 95% confidence interval, 0.32-0.95; P = .03) and NVAF (adjusted HR, 0.59; 95% CI, 0.68; P < .001) compared with patients not receiving anticoagulant therapy.Conclusion: Patients undergoing CABG surgery had a longer risk of thromboembolic new POAF than those undergoing NVAF. These data do not support the view that de novo POAF should be considered the same as primary NVAF in terms of long-term thromboembolic risk.
Medicine
Seyedeh Zahra Nazardani; Shohreh Nourizadeh Dehkordi; Ali Ghorbani
Abstract
Evaluating the master’s degree program in Sports Physiotherapy in order to improve the quality of education in this field. The need to pay attention to the effectiveness and efficiency of the education and improving the system of higher education by becoming more aware of the factors involved is ...
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Evaluating the master’s degree program in Sports Physiotherapy in order to improve the quality of education in this field. The need to pay attention to the effectiveness and efficiency of the education and improving the system of higher education by becoming more aware of the factors involved is necessary. The aim of this study is to evaluate the educational program for master’s degree in Sports Physiotherapy. This is a hybrid study in which qualitative and quantitative methods for data collection were used. The research team consisted of faculty members and sports physiotherapy students. In the first part of the study, due to a lack of standard questionnaires, the method of an expert panel was used to build the tools. In the second part, the questionnaire was distributed among 22 professors and students, and the data was collected. The findings showed that according to the viewpoints of the faculty members and students, the courses in the program are necessary and facilitates the students to become qualified in meeting their future professional requirements. The findings of other research indicate the desirability of the content, implementation, and educational facilities of the program from the viewpoint of the professors, and unfavourable from the viewpoint of the students. Moreover, from the perspective of the professors and students, the teaching methods is appropriate to the type of course and there is no need to add a new course to the program. The findings of student evaluation methods showed that these methods were considered to be favourable from the viewpoint of the professors, and unfavourable from the viewpoint of the students. As a result, the program of Sports Physiotherapy was evaluated, in terms of its favourability, with the existing courses. Nevertheless, the addition of practical and clinical units helps to improve the quality of the curriculum.
Medicine
Sadigheh Musaei
Abstract
Pregnancy is a period of deep hormonal and metabolic changes that the body endures for a relatively short period of time, during which many changes occur in the skin, nails and hair. Rashes and skin changes are extremely common during pregnancy. Due to the specific mental and emotional conditions of ...
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Pregnancy is a period of deep hormonal and metabolic changes that the body endures for a relatively short period of time, during which many changes occur in the skin, nails and hair. Rashes and skin changes are extremely common during pregnancy. Due to the specific mental and emotional conditions of pregnant women, these changes can cause concerns that may be related to appearance, the possibility of recurrence in subsequent pregnancies, potential effects on the fetus, or a combination of them. The skin changes observed during pregnancy are not all of the same importance. Some of them are common skin changes that can be seen in almost all pregnant women. Of course, there are a number of skin diseases that are specifically associated with pregnancy. Also, pregnancy can aggravate or alleviate many skin diseases that are not specific to this period.
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
Khosrow Hashemzadeh; Marjan Dehdilan
Abstract
Introduction: Cardiovascular care has become an important part of the continuity of care for cardiac patients. Its use is recommended in today's cardiac diagnostic procedures. Despite well-documented morbidity and mortality outcomes, cardiac services are underutilized. The basic principles of cardiac ...
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Introduction: Cardiovascular care has become an important part of the continuity of care for cardiac patients. Its use is recommended in today's cardiac diagnostic procedures. Despite well-documented morbidity and mortality outcomes, cardiac services are underutilized. The basic principles of cardiac therapy are explained in detail. Improvements in cardiac referrals, recording, and completion are possible using new performance measures. Material and Methods: Most guidelines recommend moderate-intensity exercise (60 to 75% of your maximum heart rate based on your target heart rate or ideal heart rate) for at least 30 minutes a day, at least 5 days a week, and preferably every day. Borg aerobic exercise, such as brisk walking, should be supplemented with daily water sports (such as walking after work, gardening, and housework). Results: Regular physical activity has been shown to have many cardiovascular benefits, including weight loss, lowering blood pressure, controlling diabetes and improving blood lipids. An analysis of 11 rehabilitation studies involving 115 patients found that regular physical activity was associated with a 28% reduction in all-cause mortality (6.2% vs. 9.0%) with a difference of 0.72, 95% CI 0.54–0.95)), there was a 24% reduction in myocardial infarction recurrence, but this was not significant (hazard ratio 0.76, 95% CI 0.57–1). Conclusion: Cardiovascular therapy has been shown to be safe and effective in improving quality of life and reducing morbidity and mortality in cardiac patients. Despite proven benefits, it is still not used in the treatment of heart disease. More patients will benefit from effective technology by improving referral and participation in cardiovascular care programs and personalized services involving the patient's condition.
Medicine
Vahid Fattahi; Mohammad Irajian
Abstract
The term arthroplasty refers to joint replacement through open surgery, which is used for cases where the joint has lost its function and the patient no longer has the ability to perform daily activities in the joint. In patients with knee osteoarthritis (arthrosis), the concentration of hyaluronic acid ...
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The term arthroplasty refers to joint replacement through open surgery, which is used for cases where the joint has lost its function and the patient no longer has the ability to perform daily activities in the joint. In patients with knee osteoarthritis (arthrosis), the concentration of hyaluronic acid in the synovial fluid is lower than the normal value. As a result, by injecting hyaluronic acid (viscosupplementation), the patient's knee pain is reduced and the patient can carry out his daily activities as before. The pain reduction effect of hyaluronic acid injection usually lasts for 3 to 9 months, and after this period, the injection can be repeated up to 2 times. At this time, the surgeon can replace the joint by considering the patient's physical conditions as well as his age and activities. Joint replacement or arthroplasty is one of the methods considered to treat patients with advanced arthritis. Complications after arthroplasty are things that can be reduced by specialized physiotherapy. Many patients will gain appropriate abilities after surgery and recovery in physiotherapy clinics in such a way that they will return to normal conditions in daily activities, but some of them may need to extend the sessions or at least reduce the pain after surgery in different ways. The useful life of the joints depends on their conditions and how their use is different in different people and mainly the joints that bear more weight or those joints that are used more are more exposed to joint damage and destruction such as arthritis. Also, diseases such as rheumatic diseases, metabolic disorders can lead to the destruction of joints and the need for joint replacement. Most of the involved joints include hip and knee, and the incidence of involvement of these two joints is much higher than other joints.
Medicine
Khosrow Hashemzadeh; Marjan Dehdilan
Abstract
Introduction: Coronary artery bypass grafting (CABG) surgery is associated with a high frequency of allogeneic blood transfusions in CABG patients due to acquired hemostatic complications. However, allogeneic blood transfusion increases the risk of infection, morbidity and mortality, as well as prolonged ...
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Introduction: Coronary artery bypass grafting (CABG) surgery is associated with a high frequency of allogeneic blood transfusions in CABG patients due to acquired hemostatic complications. However, allogeneic blood transfusion increases the risk of infection, morbidity and mortality, as well as prolonged hospital stay and increased hospital costs. It is important to identify patients who need injections to reduce their risk and minimize the use of allogeneic blood. The aim of this study was to determine the factors affecting the decision of red blood cell transplantation in patients undergoing elective primary CABG.Material and Methods: This is a cross section search based on reverse data analysis. All patients who underwent elective primary CABG were included in this study. Variables analyzed included age, gender, body weight, pre-hemoglobin (Hb) levels, patient comorbidities, and other medical conditions. Data were analyzed using SPSS software version 20.Results: 83.4% patients underwent RBC transfusion. Based on multiple logistic regression analysis, age only (odds ratio [OR] = 1.040, 95% confidence interval [CI]: 1.003, 1.001), Hb level (OR = 0.500, 95% CI: 0.387, 0.644, P < 0.001), and extracorporeal circulation time (OR = 1. 013, 95% CI: 1.004, 1.023, P < 0.001) was an important indicator of RBC cycle.Conclusion: By classifying patients according to the risk of RBC transfusion, high-risk patients can be identified and should be included in blood transfusion programs to reduce the risk of allogeneic infections.
Medicine
Amir Abbas Esmaeilzadeh; Fatemeh Nasirzadeh
Abstract
Breast cancer, which is caused by rapid and abnormal growth of cells in the breast, is a complex disease in which many factors can be involved. Some factors such as age, family history, genetics and gender are not under the control of the individual. However, a person can control other factors such as ...
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Breast cancer, which is caused by rapid and abnormal growth of cells in the breast, is a complex disease in which many factors can be involved. Some factors such as age, family history, genetics and gender are not under the control of the individual. However, a person can control other factors such as smoking, physical activity, proper weight and diet to prevent breast cancer. Some researchers believe that diet can be responsible for 30-40% of all cancers. This study raises an interesting point in research to identify breast cancer risk by focusing on estrogen- or progesterone-enhancing chemicals. However, without in vivo studies, it is premature to attempt to make a definitive connection. A multifaceted approach is necessary to fully understand the role that chemicals play in the development of breast cancer. According to Dr. Truss, this should include all data from cell studies, animal studies, and human observations. The human body is [also] very complex, and studying one piece of the puzzle individually may be very different than what happens when all the pieces are put together, said Dr. Lauren Truss. Dr. Gramley added: "Even if the findings are interesting, we can't take it and apply it to humans." Evaluating the effects of these chemicals on humans is still challenging and most of them have not been studied enough. So we expect more care to be taken in interpreting observations of chemically induced changes in breast tissue, Rudel said. A new cell culture study joins the list of research investigating the link between environmental chemicals and breast cancer. Although this is a bold and premature claim, the paper overlaps with what experts currently believe. A new study suggests that certain synthetic chemicals can increase the risk of breast cancer by stimulating hormones.
Medicine
Mohammad Irajian; Vahid Fattahi
Abstract
Introduction: Most patients experience moderate to severe pain after ankle surgery. Early and appropriate treatment of postoperative pain is essential for effective treatment that leads to preservation of lung function, normal breathing, rehabilitation and prevention of chronic pain. In this retrospective ...
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Introduction: Most patients experience moderate to severe pain after ankle surgery. Early and appropriate treatment of postoperative pain is essential for effective treatment that leads to preservation of lung function, normal breathing, rehabilitation and prevention of chronic pain. In this retrospective study, we aimed to identify potential predictors of moderate-to-severe postoperative pain in the post-anesthesia care unit (PACU) in patients undergoing gastric bypass surgery.Material and Methods: In this systematic review VAS/vNRS score of 4-6 is considered moderate, and 7-10 is considered severe. Additional factors investigated included time from ankle fracture to surgery, anesthesia procedure, preoperative anesthesia, medication use and postoperative medication use, classification radiation, bone complexity, surgical technique, and tourniquet operative time.Results: Data from 336 patients who underwent ankle arthroplasty between January 2009 and December 2022 were analyzed. None of the following variables had a significant effect on pain; age, weight, smoking, time from fracture to surgery, type of anesthesia, opioids to control dysfunction, complexity of the fracture, surgical procedure or tourniquet technique increase. Gender predicted moderate to severe pain after PACU by 2 differences.31 (1.39–3.86, P = 0.001). To our knowledge, this is the first study to report gender differences in pain reporting in the hours following joint surgery.Conclusion: Female patients who had surgery for ankle sprains reported higher pain scores in the PACU than men.
Medicine
Amir Abbas Esmaeilzadeh; Shima Kordjazi; Ataollah Salari
Abstract
Cervical cancer chemotherapy means the use of drugs that destroy cancer cells. Medicines are injected into a vein or taken by mouth as pills. These drugs enter the bloodstream and reach the whole body. For this reason, chemotherapy is used to treat uterine cancer when uterine cancer spreads to parts ...
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Cervical cancer chemotherapy means the use of drugs that destroy cancer cells. Medicines are injected into a vein or taken by mouth as pills. These drugs enter the bloodstream and reach the whole body. For this reason, chemotherapy is used to treat uterine cancer when uterine cancer spreads to parts that are not accessible for surgery. This method can be used to prevent the recurrence of the disease and its spread to other parts of the body. Chemotherapy is not used to treat endometrial cancer in stages I and II. Chemotherapy is often prescribed in a cycle, meaning a period of treatment and a period of rest. Chemotherapy drugs may be administered on one or more days per cycle. Uterine cancer chemotherapy can be administered intravenously, tablets, ointments and injections. Treatment is often done as an outpatient visit in a hospital, clinic, and in very few cases at home. In most cases, you can return home after the treatment, but in some cases, you may need to stay in the hospital for a while. Chemotherapy can be very hard on your veins, so having a venous access device or an indwelling catheter during treatment can be a good option. The catheter is a thin and flexible tube that may be placed in your body so that there is no need to insert the catheter into the body during subsequent treatments. One end of the catheter is placed in a vein near your heart.
Medicine
Amin Moradi; Naghi Abedini
Abstract
Introduction: Our study compared the effectiveness of tranexamic acid in patients undergoing TKA using the three different administration methods—IV, IA, and combined IV and IA—in terms of total blood loss and the rate of allogeneic transfusion. We also wanted to compare the frequency of ...
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Introduction: Our study compared the effectiveness of tranexamic acid in patients undergoing TKA using the three different administration methods—IV, IA, and combined IV and IA—in terms of total blood loss and the rate of allogeneic transfusion. We also wanted to compare the frequency of wound complications and venous thromboembolism (VTE) among these regimens.Material and Methods: 66 TKA patients were divided into four groups based on the route of tranexamic acid administration: IV only, IA only, low-dose combined (IV + IA injection of 1 g), and high-dose combined (IV + IA injection of 2 g). This research involved 66 patients who underwent TKA between March 2019 and March 2020. Comparing the groups revealed differences in the estimated total blood loss, allogeneic transfusion rate, hemoglobin loss, frequency of symptomatic deep vein thrombosis and pulmonary embolism, wound complications, and periprosthetic joint infection.Results: There were no differences between the other three groups, but the combined high and low dose group and the IA only group lost less blood overall than the IV only group did. None of the study groups' patients received an allogeneic transfusion. There were no other symptomatic VTE events in any group, with the exception of one patient in the IV-only group who developed a symptomatic pulmonary embolism.Conclusion: Regardless of whether it is combined with IV administration, IA tranexamic acid administration further reduces blood loss after unilateral TKA compared to IV use alone. With respect to further reducing blood loss in comparison to IA alone, this study did not find any additional effects of IV combination.
Medicine
Ramesh Baradaran Bagheri
Abstract
Introduction: The common perception that this treatment has no serious side effects is probably influenced by this flawed evidence. In this large population-based study, our goals were to determine whether there was an independent relationship between the amount of oxytocin exposed during labor and the ...
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Introduction: The common perception that this treatment has no serious side effects is probably influenced by this flawed evidence. In this large population-based study, our goals were to determine whether there was an independent relationship between the amount of oxytocin exposed during labor and the risk of developing severe PPH and to determine whether the prophylactic use of oxytocin after delivery affected this relationship. Material and Methods: women who had straightforward pregnancies and delivered term singletons vaginally. Cases were 1483 women with severe PPH, which was indicated by peripartum hemoglobin changes of less than 4 g/dl or the requirement for blood transfusions. 90 women from a randomly selected group of expectant mothers without PPH served as the controls. Using two-level multivariable logistic regression modeling, the independent relationship between the oxytocin level during labor and the risk of developing severe PPH was examined and quantified with ORs. Results: After adjusting for all possible confounders, oxytocin exposure during labor was linked to a higher risk of severe PPH when prophylactic oxytocin was not given after delivery. With more oxytocin injected, the association became stronger. The risk of severe PPH was approximately three times higher for total doses between 2 and 4 IU and six times higher for total doses over 4 IU. Conclusion: A separate risk factor for severe PPH appears to be oxytocin during labor. Our findings add to the body of evidence highlighting the need for precautions to reduce maternal complications when oxytocin is used to speed up labor, including strict indications, the use of the lowest effective dose, and careful efficacy evaluation.
