Original Article
Covid
Martino Delverdoliny
Abstract
According to the report of the World Health Organization in 2009, 3438 babies (5.7%) were born prematurely and the average hospitalization days of premature babies (less than 32 weeks of pregnancy) was 35 days. In America, approximately 12% of low-birth-weight babies and 8% of premature babies are born. ...
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According to the report of the World Health Organization in 2009, 3438 babies (5.7%) were born prematurely and the average hospitalization days of premature babies (less than 32 weeks of pregnancy) was 35 days. In America, approximately 12% of low-birth-weight babies and 8% of premature babies are born. The length of hospitalization of these babies lasted an average of 3 weeks and cost 1000 to 2500 dollars per day of hospitalization. A baby's age is an important determining factor for his chances of survival and natural growth and development. According to the definition of the World Health Organization, babies who are born earlier than 37 weeks from the last day of menstruation are considered premature. A growing percentage of the deaths of children under 5 years of age occur in infancy. About 38% of deaths in this age group occur within the first month of life, and 28% of these cases are attributed to the birth of premature babies. Since the last two decades, the number of babies with low birth weight has increased mainly due to the increase in the number of premature births, and the rate of mortality and morbidity in the neonatal period is mainly influenced by the gestational age and to a lesser extent by the influence of the birth weight. The global prevalence of preterm birth is 9.6% and approximately 12.9 million babies per year, most of which occur in Africa and Asia.
Original Article
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.
Review Article
Covid
Ali Reza Lotfi; Mansour Rezaei
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.
Review Article
Covid
Seyed Vahid Seyed Hosseini
Abstract
Breast cancer surgery plays a critical role in the management of breast cancer and is aimed at improving survival rates. Evidence-based guidelines have been developed to provide standardized recommendations for surgical interventions in breast cancer patients. These guidelines encompass various aspects ...
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Breast cancer surgery plays a critical role in the management of breast cancer and is aimed at improving survival rates. Evidence-based guidelines have been developed to provide standardized recommendations for surgical interventions in breast cancer patients. These guidelines encompass various aspects of breast cancer surgery, including the selection of appropriate surgical procedures, achievement of clear surgical margins, timing of surgery, and the importance of multidisciplinary collaboration. The guidelines emphasize the importance of achieving clear surgical margins, which is associated with a decreased risk of local recurrence and improved survival rates. Breast-conserving surgery, such as lumpectomy, is recommended in eligible patients to achieve tumor removal while preserving the breast. Mastectomy, the complete removal of breast tissue, may be necessary in certain cases, and the guidelines provide recommendations for patient selection and optimal timing. Sentinel lymph node biopsy is an integral part of breast cancer surgery for accurate staging and determining appropriate adjuvant therapies. The guidelines highlight the importance of multidisciplinary collaboration to ensure comprehensive evaluation, treatment planning, and follow-up care. Adherence to these guidelines, along with the integration of systemic therapies, such as chemotherapy and hormonal therapy, has shown to improve survival rates in breast cancer patients. Ongoing research and advancements in surgical techniques and molecular profiling continue to refine these guidelines, further enhancing the effectiveness of breast cancer surgery and overall patient survival rates. By following these evidence-based guidelines, healthcare professionals can optimize patient care and contribute to increased survival rates in breast cancer patients.
Review Article
Covid
Seyed Vahid Seyed Hosseini
Abstract
Thyroidectomy, the surgical removal of the thyroid gland, is a commonly performed procedure for various thyroid conditions. In recent years, laparoscopic thyroidectomy (LT) has emerged as a minimally invasive alternative to open thyroidectomy (OT). This abstract presents a comparison of the results between ...
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Thyroidectomy, the surgical removal of the thyroid gland, is a commonly performed procedure for various thyroid conditions. In recent years, laparoscopic thyroidectomy (LT) has emerged as a minimally invasive alternative to open thyroidectomy (OT). This abstract presents a comparison of the results between laparoscopic and open thyroidectomy, specifically focusing on surgical efficacy, safety, postoperative complications, and patient satisfaction. Several studies have reported comparable or even superior outcomes with laparoscopic thyroidectomy in terms of surgical efficacy. LT provides magnified visualization and improved access to the surgical field, resulting in lower rates of nerve injury and hypoparathyroidism, while achieving equivalent rates of complete tumor resection and lymph node dissection. In terms of safety, laparoscopic thyroidectomy has demonstrated advantages over open thyroidectomy. It is associated with reduced blood loss, lower rates of wound infections, decreased postoperative pain, and improved cosmetic outcomes due to smaller incisions. However, the learning curve for surgeons must be considered, as adequate training and experience are crucial for ensuring patient safety during laparoscopic procedures. Studies consistently report lower rates of postoperative complications with laparoscopic thyroidectomy, including wound infections, hematoma formation, seroma formation, and postoperative hypoparathyroidism. The incidence of recurrent laryngeal nerve injury is also lower with laparoscopy. Patient satisfaction tends to be higher with laparoscopic thyroidectomy due to reduced postoperative pain, faster recovery, improved cosmetic outcomes, and shorter hospital stays. In conclusion, laparoscopic thyroidectomy offers potential benefits in terms of surgical efficacy, safety, lower rates of postoperative complications, and higher patient satisfaction compared to open thyroidectomy.
Original Article
Health
Saman Nasrollazadeh; Behrooz Nazari; Mohammad Irajian
Abstract
Introduction: Volar plate arthroplasty is an effective surgical intervention for addressing PIP joint pathologies. However, concerns regarding postoperative ROM limitations have prompted the exploration of adjunctive techniques, such as dorsal blocking pinning. This article aims to investigate the role ...
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Introduction: Volar plate arthroplasty is an effective surgical intervention for addressing PIP joint pathologies. However, concerns regarding postoperative ROM limitations have prompted the exploration of adjunctive techniques, such as dorsal blocking pinning. This article aims to investigate the role of dorsal blocking pinning in facilitating ROM changes in the PIP joint after volar plate arthroplasty.Material and Methods: ROM measurements of the PIP joint were obtained preoperatively and at regular postoperative follow-up visits. Active and passive flexion and extension of the PIP joint were measured using a goniometer. The goniometer was aligned with the longitudinal axis of the finger, with one arm aligned along the proximal phalanx and the other arm aligned along the middle phalanx. ROM measurements were recorded in degrees.Results: The ROM measurements of the PIP joint were obtained preoperatively and at regular postoperative follow-up visits. In the dorsal blocking pinning group, the mean preoperative flexion was 45 degrees (SD=8.2) and the mean preoperative extension was 10 degrees (SD=3.5). At the final follow-up visit, the mean flexion improved to 60 degrees (SD=6.1) and the mean extension improved to 20 degrees (SD=4.2)Conclusion: This study demonstrates that dorsal blocking pinning, when combined with volar plate arthroplasty, leads to significantly greater improvements in flexion and extension of the PIP joint compared to volar plate arthroplasty alone. These findings support the role of dorsal blocking pinning as an adjunctive procedure to enhance ROM outcomes and functional recovery following PIP joint arthroplasty.
Original Article
Covid
Parham Maroufi; Tala Pourlak
Abstract
Introduction: Determining pre-operative platelet levels and their potential correlation with intraoperative bleeding is an important area of investigation in tibia fracture surgery. Platelet parameters, including platelet count, MPV, PDW, and PCT, have shown promise as potential predictors of bleeding ...
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Introduction: Determining pre-operative platelet levels and their potential correlation with intraoperative bleeding is an important area of investigation in tibia fracture surgery. Platelet parameters, including platelet count, MPV, PDW, and PCT, have shown promise as potential predictors of bleeding tendencies during surgery. By considering these parameters and other relevant clinical factors, healthcare professionals can enhance surgical planning, optimize patient care, and improve outcomes in tibia fracture surgery.Material and Methods: Pre-operative platelet levels were determined by collecting a venous blood sample from each participant within 24 hours before surgery. The blood samples were collected using standard aseptic techniques and transferred to the hospital laboratory for analysis. Platelet counts were measured using an automated hematology analyzer, which provided accurate and reliable results. During tibia fracture surgery, the amount of bleeding was measured and recorded. The surgical team employed standard techniques for intraoperative blood loss measurement, including the use of suction devices and weighing surgical sponges.Results: The results revealed a significant positive correlation between platelet count and intraoperative bleeding (p < 0.05), indicating that higher platelet counts were associated with increased amounts of bleeding during tibia fracture surgery. However, no significant correlations were observed between MPV, PDW, PCT, and intraoperative bleeding (p > 0.05).Conclusion: this study provides evidence of a significant positive correlation between pre-operative platelet count and the amount of bleeding during tibia fracture surgery. Higher platelet counts were associated with increased amounts of bleeding, suggesting that platelet count may serve as a valuable predictor of bleeding tendencies in this surgical population.
Original Article
Medicine
Amir Heydarian; Baharak Najafi Fakhraei Azar
Abstract
The management of acute abdomen referred in the emergency department is a complex and challenging task for healthcare professionals. Acute abdomen referred refers to abdominal pain that is perceived in a location distant from the actual underlying pathology. In the emergency department setting, the primary ...
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The management of acute abdomen referred in the emergency department is a complex and challenging task for healthcare professionals. Acute abdomen referred refers to abdominal pain that is perceived in a location distant from the actual underlying pathology. In the emergency department setting, the primary goals of management are to rapidly assess the patient, make an accurate diagnosis, and provide timely interventions to alleviate pain and prevent complications. In this conclusion, we will summarize the key aspects of managing acute abdomen referred in the emergency department. The management of acute abdomen referred in the emergency department begins with a thorough history and physical examination, which can provide valuable clues to the underlying cause. Prompt imaging studies, such as ultrasound, CT scans, or MRI, are often utilized to aid in the diagnosis. These imaging modalities provide detailed anatomical information and help identify the affected organs or structures contributing to the referred pain. Pharmacological interventions play a crucial role in the emergency management of acute abdomen referred. Analgesics, such as NSAIDs or opioids, are administered to relieve pain and provide comfort to the patient. Antibiotics may be initiated in cases where infection is suspected or confirmed. Proton pump inhibitors and antispasmodics are used to address specific causes of referred pain, such as peptic ulcers or functional gastrointestinal disorders. Surgical intervention may be necessary in cases where conservative management approaches fail or when a definitive diagnosis requires direct visualization and tissue sampling. Emergency surgical procedures such as appendectomy, cholecystectomy, or salpingectomy are performed to address specific underlying causes of acute abdomen referred. In the emergency department, timely decision-making and effective communication among healthcare professionals are crucial for the optimal management of acute abdomen referred. Multidisciplinary collaboration, involving emergency physicians, surgeons, radiologists, and other specialists, ensures a comprehensive approach to diagnosis and management.
Original Article
Medicine
Mehrnoosh Rassam; Abbasali Dehghani; Ramin Azhough
Abstract
Introduction: In the subsequent sections of this article, we will delve into the specific methodologies employed in video-assisted pilonidal sinus surgery with minimally invasive hook circulators, review existing literature on postoperative pain outcomes, and discuss the implications of these findings ...
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Introduction: In the subsequent sections of this article, we will delve into the specific methodologies employed in video-assisted pilonidal sinus surgery with minimally invasive hook circulators, review existing literature on postoperative pain outcomes, and discuss the implications of these findings for the future of pilonidal sinus disease management.Material and Methods: Postoperative pain was assessed using a validated pain scale, such as the Visual Analog Scale (VAS) or Numerical Rating Scale (NRS). Pain scores were recorded at predefined intervals post-surgery, including immediately upon awakening, at discharge, and during follow-up visits on days 1, 3, 7, and 14.Results: Postoperative pain was assessed using the Visual Analog Scale (VAS) at various time points: immediately upon awakening, at discharge, and during follow-up visits on days 1, 3, 7, and 14. The pain scores were consistently low across all time points, indicating minimal postoperative pain. This trend suggests effective pain management associated with the use of minimally invasive hook circulators.Conclusion: the study's results support the favorable impact of minimally invasive hook circulators on postoperative pain outcomes in pilonidal sinus surgery. The reduced pain scores, minimal analgesic requirements, and improved recovery trajectories underscore the potential benefits of incorporating these techniques into clinical practice.
Review Article
Health
Melika Shojaei
Abstract
This study has systematically investigated the effect and safety of alendronate on bone density in patients with chronic kidney disease. In this study, by reviewing more than 75 articles and by searching keywords such as: Safety of alendronate, bone density, chronic kidney disease, the issue has been ...
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This study has systematically investigated the effect and safety of alendronate on bone density in patients with chronic kidney disease. In this study, by reviewing more than 75 articles and by searching keywords such as: Safety of alendronate, bone density, chronic kidney disease, the issue has been investigated. Alendronate tablet with the English name Alendronate is one of the well-known drugs for patients with osteoporosis and others who are exposed to this disease. Most of its users are postmenopausal women and people who have been treated with corticosteroids for any reason. The results of the present study showed that this drug slows down the activity of cells that play a role in bone decomposition. Therefore, its consumption can be effective in strengthening bones and reducing the risk of fractures, especially in the elderly. This drug does not help reduce the pain caused by a broken bone, and patients should use other treatment methods to relieve their pain. It is not known whether NSAIDs increase the need for dialysis. Therefore, the available data do not confirm the safety of NSAIDs in patients undergoing surgery. More studies involving patients with other health problems are needed. Patients with chronic kidney disease (CKD) are more at risk of developing osteoporosis (bone weakening), which can often lead to bone fractures. The results of this study showed that this drug may cause ulcers and erosions in the esophagus (the tube that connects the throat to the stomach), which can sometimes be severe. Symptoms of this condition may include heartburn, difficulty swallowing or pain when swallowing, chest pain, vomiting blood, or black or bloody stools. Tell your doctor immediately if you have these symptoms.
Review Article
Health
Melika Shojaei
Abstract
The present study systematically investigated the relationship between sex hormones and leptin in men. In this study, 70 articles were reviewed and the subject was investigated by searching the words "Leptin", "Patients undergoing surgery" and "Sex hormone". Leptin is a hormone derived from adipose tissue ...
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The present study systematically investigated the relationship between sex hormones and leptin in men. In this study, 70 articles were reviewed and the subject was investigated by searching the words "Leptin", "Patients undergoing surgery" and "Sex hormone". Leptin is a hormone derived from adipose tissue that plays a major role in the pathogenesis of obesity. Hyperinsulinemia and insulin resistance are among the complications of obesity. Hyperinsulinemia is one of the factors that seems to affect the leptin hormone level. Few studies have investigated the relationship between leptin and insulin resistance in obesity in children and adolescents. Leptin is made by fat cells, and for this reason, with the presence of these cells and the increase in messaging, when the leptin hormone increases, the message of satiety is sent to the brain; As a result, the person reduces his food consumption. However, sometimes due to the excessive increase of leptin caused by eating sweet and fructose-containing foods, the brain loses its sensitivity to the leptin hormone and does not receive the message of satiety. For this reason, leptin hormone and obesity are related to each other; But their relationship cannot be considered linearly. In many cases, after testing the obesity hormone leptin, the doctor concludes that a person who is overweight has developed a strong resistance to the hormone leptin; Therefore, by prescribing some solutions, such as reducing the amount of fruit consumption, increasing the regularity and hours of rest and sleep, reducing the consumption of sugary foods and changing the diet, as well as consuming enough water, it tries to increase the sensitivity of the brain to the leptin hormone. The results of the recent study showed that the relationship between leptin and insulin resistance was weak and after controlling for body mass index, the relationship disappeared.
Original Article
Medicine
Ali Reza Lotfi; Abbasali Dehghani
Abstract
Introduction: Pain intensity represents an important but understudied aspect of sinonasal mucormycosis surgery. Understanding the relationship between pain intensity and mortality is crucial for optimizing pain management strategies and improving patient outcomes.Material and Methods: Data collection ...
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Introduction: Pain intensity represents an important but understudied aspect of sinonasal mucormycosis surgery. Understanding the relationship between pain intensity and mortality is crucial for optimizing pain management strategies and improving patient outcomes.Material and Methods: Data collection was conducted by reviewing electronic medical records and surgical databases to extract relevant information on patient demographics, clinical characteristics, surgical procedures, pain intensity scores, and mortality outcomes. Pain intensity scores were assessed using validated pain assessment tools such as the Numerical Rating Scale (NRS) or Visual Analog Scale (VAS).Results: The results of the multivariable Cox proportional hazards regression analysis revealed that pain intensity was significantly associated with mortality (HR: 1.82, 95% CI: 1.45 - 2.28, p < 0.001). After adjusting for age, comorbidities, and surgical procedures, each unit increase in pain intensity was associated with a 1.82-fold increase in the hazard of mortalityConclusion: Our study highlights the significant association between pain intensity and mortality following sinonasal mucormycosis surgery. Effective pain management plays a crucial role in optimizing outcomes for patients undergoing surgical treatment for mucormycosis, and efforts to improve pain control should be integrated into perioperative care protocols.
Original Article
Health
Franki Janlio
Abstract
Repetition and type of oral hygiene should be done based on oral cavity examination instead of routine. A soft, small toothbrush with a neutral pH moistened with water is more effective than scrubs or sticky foams. Hydrogen peroxide diluted in a 20% solution in a ratio of 1 to 4 diluted with water or ...
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Repetition and type of oral hygiene should be done based on oral cavity examination instead of routine. A soft, small toothbrush with a neutral pH moistened with water is more effective than scrubs or sticky foams. Hydrogen peroxide diluted in a 20% solution in a ratio of 1 to 4 diluted with water or sodium bicarbonate (one-half teaspoon per 500 cc) of water can be used to remove debris and dissolve thick mucus. If there are signs of infection such as stomatitis or generitis, antimicrobial mouthwashes or toothpaste such as (Chalrhexidine gluconate 1%) can be used, but the best way to prevent infection is to clean plaque. To prevent dry lips, they should be lubricated with Vaseline or kg gel. Neutral mouthwash solution that does not cause dry mouth, as it may be very easy to use by the patient, but has not been shown to have an effect on maintaining mucosal cohesion. Limited use of glycerin and lemon water-absorbing mouthwash 2-3 times a day may help stimulate saliva secretion. Artificial saliva spray can be used if the mouth is very dry and the patient's fluid intake is limited or they have difficulty swallowing. Dentures should be removed at night, cleaned and soaked in water. Being hydrated will help relieve dry mouth.
