Review Article
Medicine
Khosro Kolahdouzan; Behrooz Nazari
Abstract
Ankle arthroplasty and total ankle arthroplasty are two important treatments for end-stage degenerative ball. Its results on the biomechanics of the medial foot are not sufficient to determine which is better. This study compared the biomechanical parameters of feet treated with ankle arthrodesis, feet ...
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Ankle arthroplasty and total ankle arthroplasty are two important treatments for end-stage degenerative ball. Its results on the biomechanics of the medial foot are not sufficient to determine which is better. This study compared the biomechanical parameters of feet treated with ankle arthrodesis, feet treated with total ankle arthroplasty, and healthy feet using statistical analysis. A validated tripod finite element model was designed to simulate the stance phase of gait. The results showed that total ankle arthroplasty provides more stable plantar pressure distribution than ankle arthrodesis. Among all replacements, the mean scaphoid joint had the highest contact pressure of 3.17 MPa. Surgery does not result in deep subscalar fusion. In both surgical models, an increase was achieved in the maximum metatarsals, especially in the second and third metatarsals. This study allows us to look at the internal biomechanics of foot defects and feet treated with total ankle arthroplasty and ankle arthrodesis during walking.
Original Article
Medicine
Abdolreza Mehdinavaz Aghdam; Fariborz Rousta
Abstract
Introduction: Another rare surgical cause of voice change after thyroidectomy is cervical muscle injury Causes of failure may include pulmonary edema, edema, or airway obstruction. The aim of this study was to determine the frequency of unplanned parathyroidectomy, unplanned parathyroidectomy, postoperative ...
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Introduction: Another rare surgical cause of voice change after thyroidectomy is cervical muscle injury Causes of failure may include pulmonary edema, edema, or airway obstruction. The aim of this study was to determine the frequency of unplanned parathyroidectomy, unplanned parathyroidectomy, postoperative hypocalcemia and the risk of unplanned parathyroidectomy in patients undergoing thyroid surgery in our clinic. Material and Methods: Comparison of postoperative Ca value with age, gender, preoperative Ca value, dominant nodule diameter on ultrasonography (USG), type of surgery (total/lobectomy), and histopathological findings of thyroidectomy material (malignant/benign, with or without incident parathyroidectomy) is closed. Blood calcium levels below 8 mg/dL, measured after the first 24 hours after surgery, are indicative of postoperative hypocalcemia. Results: There was no relationship between nodule diameter and hypocalcemia. When patients were divided into malignant and benign groups, there was no significant difference between these groups in terms of performance after hypocalcemia. When patients were divided into groups with and without incident parathyroidectomy, there was no significant difference in postoperative hypocalcemia between these groups. Conclusion: In our study, female gender, age <28.5 years, low preoperative Ca value and total thyroidectomy were considered to be associated with hypocalcemia. Although there is no association between parathyroidectomy and postoperative hypocalcemia, this problem can be avoided by careful removal and imaging of the thyroid gland, especially in patients including patients with malignant thyroidectomy and total thyroidectomy.
Original Article
Medicine
Khosrow Hashemzadeh; Marjan Dehdilan
Abstract
Introduction: Our aim was to record preoperative and postoperative results in patients undergoing coronary artery bypass grafting, to examine the factors affecting reoperation, and to determine whether there is a gender difference in pre- and post-activity activity using the Duke Activity Status Index. ...
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Introduction: Our aim was to record preoperative and postoperative results in patients undergoing coronary artery bypass grafting, to examine the factors affecting reoperation, and to determine whether there is a gender difference in pre- and post-activity activity using the Duke Activity Status Index. Material and Methods: 151 patients who underwent isolated coronary artery bypass grafting. The median time from baseline to return to work after Duke Success for women and men was 8.0 months. In addition to baseline scores at postoperative follow-up, the effects of 47 variables were analyzed with logistic ordinal models. The appropriate model for subsequent scores was determined by reverse selection, keeping the variables if they met the criteria for a P-value less than 0.05.Results: Average scores on the Duke Activity Status Index (women, 21.5; men, 32.2; P < .001) and pretest scores (42.7 for women; 58.2 for men; P < .001) were lower in women than in men. Postoperative scores were lower in elderly patients with obstructive pulmonary disease, myocardial infarction, stroke, diabetes, vascular disease, severe postoperative pain, and return to the operating room. After adjusting for these factors, recovery scores remained lower for women (difference from men, 2.1 [95% confidence interval, 1.7-2.6]; P < .001).Conclusion: A number of preoperative, surgical variables, and postoperative factors are associated with functional recovery after coronary revascularization. Additionally, after adjusting for these variables, female sexuality was later associated with lower performance.
Original Article
Medicine
Marjan Dehdilan; Khosrow Hashemzadeh
Abstract
Introduction: In adults, readmission within 30 days of heart surgery is a major factor in hospital costs for heart surgery, but current data on risk factors for readmission are scarce. Therefore, we sought to identify performance-adjusted risk factors for coronary artery bypass graft (CABG) re-admissions.Material ...
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Introduction: In adults, readmission within 30 days of heart surgery is a major factor in hospital costs for heart surgery, but current data on risk factors for readmission are scarce. Therefore, we sought to identify performance-adjusted risk factors for coronary artery bypass graft (CABG) re-admissions.Material and Methods: The records of patients who underwent CABG at our institution between 2012-14 were analyzed for contrast with prospectively recorded case studies, including New York Cardiac Surgery Reporting System (CSRS) events, prescriptions, and testing costs.Results: Read rate 13% ; The CSRS estimated value is 8.7% (observed/predicted ratio = 1.5). The median time from CABG discharge to readmission was 6 days (interquartile range [IQ] 3 to 13 days). The median length of hospital stay was 4 days (IQ 2 to 7 days). The most common causes of readmission were heart disease (n = 40 [25% of readmissions]) and pneumonia (n = 36 [23%]), including pleural effusions. In addition to CSRS status, serum creatinine excretion alone was not associated with increased readings (p=0.5) OR] 5.7, %95 GA 1.7 ila 18.7).Conclusion: Readmission for coronary artery bypass surgery remains an ongoing medical challenge. Given that readmissions usually occur within the first week after discharge and are usually short-term, attention is paid to follow-up care and risk of readmission (compare, for example, abnormal serum creatinine or abnormal reactivity) and/or multiple causes of readmission. may reduce readmission after CABG (eg, pleural effusion).
Review Article
Medicine
Mohammad Irajian; Vahid Fattahi
Abstract
Introduction: Regional anesthesia is considered an important tool in postoperative pain management while minimizing opioid use. However, post-operative recovery (characterized by peripheral nerve hyperalgesia) may reduce or completely block the effect of this change, since opioids may act better after ...
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Introduction: Regional anesthesia is considered an important tool in postoperative pain management while minimizing opioid use. However, post-operative recovery (characterized by peripheral nerve hyperalgesia) may reduce or completely block the effect of this change, since opioids may act better after the blockage is removed.Material and Methods: This study was a systematic Review. We reviewed the published literature describing the pathophysiology and development of complications after peripheral artery dissection in orthopedic surgery patients. Search for related articles using PubMed, EMBASE, and Web of Science.Results: We included 28 articles (n=28) in our review. Perioperative peripheral nerve considerations and other postoperative pain management for orthopedic surgery patients are discussed. Multimodal strategies such as preemptive analgesia, intra-articular or intravenous anti-inflammatory drugs, and adjuvants in vain block fluid before block failure will reduce the burden of rebound pain.Conclusion: Additionally, educating the patient about the possibility of back pain is important to ensure proper use of pain relievers and to reduce the need for pain relief opioids. Understanding the effects of relapse and prevention of relapse is important to reduce the side effects associated with the use of opioids for regional anesthesia.
Original Article
Chemical Engineering
Amin Ahmadpour; Rozita Kaviani
Abstract
Today, the recovery of acetone as an expensive and widely used solvent in the production units of methyl methacrylate, bisphenol A, MTBA, plastics and synthetic fibers is very important. One of the most common recovery methods is the absorption process (solvent separation), which is sometimes used in ...
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Today, the recovery of acetone as an expensive and widely used solvent in the production units of methyl methacrylate, bisphenol A, MTBA, plastics and synthetic fibers is very important. One of the most common recovery methods is the absorption process (solvent separation), which is sometimes used in combination with surface absorption or membrane separation due to its cheapness and availability of knowledge. In this research, it was simulated with Aspen Plus V 7.2 software and the experimental rules of absorption and distillation columns, and with the Levi-Benn model to recover 99.5% of acetone from its mixture with air (10.3-687Mol/hour), the optimal conditions for the absorption tower, 20 equilibrium stages were obtained at atmospheric pressure with effluent and return gas from the separation section. In this situation, the molar ratio of the reflux of the distillation tower is 20.9 with the minimum energy consumption in the partial condenser at the rate of 2.3 Kw and 20 equilibrium stages.
Original Article
Health
Ramesh Baradaran Bagheri
Abstract
Introduction: According to information currently available, there has not yet been a published study about the effectiveness of intraperitoneal dexamethasone that uses high-quality methodology. However, after laparoscopy, dexamethasone intravenously has been used to treat nausea. In this study, we compare ...
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Introduction: According to information currently available, there has not yet been a published study about the effectiveness of intraperitoneal dexamethasone that uses high-quality methodology. However, after laparoscopy, dexamethasone intravenously has been used to treat nausea. In this study, we compare the efficacy of intraperitoneal dexamethasone with placebo in patients who have undergone gynecologic laparoscopy in a double-blind randomized clinical trial.Material and Methods: The patients were divided into groups using the four-block block randomization method. The groups' treatment options were chosen at random by drawing lots. There were an equal number of candidates in each block at the conclusion of the selection process. Anesthesia was administered to each patient. A 16 mg dose of dexamethasone was administered into the peritoneum of patients in the first group at the conclusion of the procedure, while patients in the second group received a placebo injection of 16 cc of normal saline.Results: Within the first 0, 2, 4, 8, and 12 hours following the procedure, the dexamethasone group experienced significantly less pain than the placebo group. The placebo group consumed more opioids on average as analgesics/sedatives than the dexamethasone group. Conclusion: Our study's findings demonstrate that, compared to a placebo, 16 mg of dexamethasone can significantly lessen the intensity of pain following gynecologic laparoscopy, and these patients also require fewer opioids. Controlling postoperative pain following laparoscopic surgery can be done in advance using this technique, which has no negative side effects.
Review Article
Health
Mehrdad Zamani Esfahlani; Ramesh Baradaran Bagheri
Abstract
Introduction: A woman's body undergoes physiological and anatomical changes during pregnancy that affect a number of systems, including the musculoskeletal system. These alterations may result in low back pain or low pelvic pain during or after pregnancy, impairing the movement of these structures and ...
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Introduction: A woman's body undergoes physiological and anatomical changes during pregnancy that affect a number of systems, including the musculoskeletal system. These alterations may result in low back pain or low pelvic pain during or after pregnancy, impairing the movement of these structures and causing discomfort. Material and methods: Using the terms "low back pain," "pelvic girdle pain," "lumbopelvic pain," "posterior pelvic pain," "pregnancy-related low back pain," "pregnancy-related pelvic girdle pain," and "pregnancy-related lumbopelvic pain," we searched the literature in Pubmed, Cochrane Library, Ovid, and Google for articles in English, Portuguese, and Spanish published in the previous 20 years or older, as appropriate. Results: In this study we focus on terminology, epidemiology, risk factors, pathophysiology, prognosis, diagnosis, and treatment, the aim of this study was to discuss the diagnosis and treatment of pregnancy-related lumbosacral pain. Conclusion: One of the main causes of lumbosacral pain is pregnancy, which is also one of the most common illnesses during gestation. Pregnant women's quality of life is improved when this pathology is properly managed.
Original Article
Chemical Engineering
Rozita Kaviani; Ahmad Omidvar; Amir Arezi
Abstract
In recent years, cogeneration systems have been considered to increase the efficiency and optimal use of energy sources for the production of electrical energy and heat energy. Electricity and heat energy cogeneration systems can achieve up to 70% efficiency, and at the realistic and subsidized rates ...
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In recent years, cogeneration systems have been considered to increase the efficiency and optimal use of energy sources for the production of electrical energy and heat energy. Electricity and heat energy cogeneration systems can achieve up to 70% efficiency, and at the realistic and subsidized rates of energy carriers, the beneficiaries of these systems supply the demand and supply sectors. In this study, the optimal working point of a system consisting of several independent units, capable of trading electricity, based on the consumption of various fuels, and utilization of storage tank was determined using genetic algorithm, and modeling accuracy were compared. Other references have also been made. The simulation results show that in the temperate seasons and summer, the cogeneration system meets all electrical and thermal requirements during the 22-23 hours due to the high electricity grid rate and at the end of 24 hours, the total cogeneration cost For almost all seasons 50% less than the conventional production system. It has also been shown that the use of absorption chillers has improved the ratio of electrical and heat loads, and the efficiency of the cogeneration system has increased compared to the previous state, and the heat energy loss has also decreased.
Original Article
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.
Original Article
Covid
Mahmoud Ali Hassan
Abstract
The purpose of coronary artery angioplasty is to revascularize the heart muscle, which is responsible for reducing angina pain and increasing life expectancy. PTCA is an invasive intervention method used in patients with angina pectoris as well as acute MI. Unstable angina that does not respond to drug ...
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The purpose of coronary artery angioplasty is to revascularize the heart muscle, which is responsible for reducing angina pain and increasing life expectancy. PTCA is an invasive intervention method used in patients with angina pectoris as well as acute MI. Unstable angina that does not respond to drug treatment and lasts less than 1 year affects the patient's quality of life. Chronic and debilitating angina and new ECG changes include ST-segment elevation and pathological Q-wave. Acute MI that lasts less than 6 hours with or without concomitant use of thrombolytic agents and patients for whom CABG is dangerous. The patient should trust the treatment team, as fear can lead to vagal attacks of PTCA failure. Initially used as an alternative non-surgical invasive treatment for patients requiring coronary artery bypass grafting, today it is an adjunctive therapy for the treatment of Acute MI with fibrinolytic drugs. Acute pulmonary edema is a condition of abnormal accumulation of fluid in the lungs. Fluid may accumulate in the interstitial space or alveoli. Acute pulmonary edema is an acute event caused by heart failure, it can be acutely caused by factors such as myocardial infarction and chronic heart failure. Myocardial infarction as an ischemic effect can reduce ventricular dilatation and its function can significantly increase cardiac output. As resistance increases, left ventricular filling causes the blood to return to the pulmonary circulation.
Original Article
Covid
Alfred Atlinkson
Abstract
The EKG electrocardiogram should be taken within 10 minutes of the patient's pain reporting on arrival at the emergency department. With the help of this device, the location and causes of MI solutions can be identified and followed up. Early signs of EKG in acute MI are due to ischemia and myocardial ...
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The EKG electrocardiogram should be taken within 10 minutes of the patient's pain reporting on arrival at the emergency department. With the help of this device, the location and causes of MI solutions can be identified and followed up. Early signs of EKG in acute MI are due to ischemia and myocardial injury. Myocardial revolarization is altered and causes a delay and reversal of the T wave, and the ischemic zone may remain repolarized until the myocardium returns to rest. Myocardial injury causes changes in the ST segment. Damaged cells naturally depolarize, but depolarize faster than normal cells. This causes the ST segment to rise at least 1 mm above the isoelectric line (the beginning of the P wave is used as a source for the isoelectric line). Myocardial injury causes an increase in the ST segment and long symmetrical T waves. The affected area will become a necrotic area if blood flow continues to decrease. ST segment changes return to baseline within a few days to 2 weeks. When ST elevation is greater than 1 mm (at least in 2 of 14 leads), MI Cute is considered. It causes the wave to be reversed to the region due to a change in repolarization, but in acute ischemia the T wave becomes long and sharp, and after this stage the flat is finally reversed. The big wave and symmetry are created within 24 hours. Reversed within 1 to 3 days with a final 1 to 2 weeks, T-wave reversal may persist for several months. Inverse T The deeper, more symmetrical, the more severe the ischemia.
Original Article
Covid
James Beki
Abstract
In the process of rehabilitation after myocardial infarction, the person returns to the desired physiological-psychological state of recreational occupation. Rehabilitation begins in the hospital immediately after admission. About the physiological anatomy of the coronary heart disease, risk factors, ...
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In the process of rehabilitation after myocardial infarction, the person returns to the desired physiological-psychological state of recreational occupation. Rehabilitation begins in the hospital immediately after admission. About the physiological anatomy of the coronary heart disease, risk factors, treatment of coronary artery disease, behavioral counseling at home at this stage. If there are no complications, the patient is usually discharged two weeks later. Before discharge, a restricted exercise program is performed to determine the strength and capacity of the patient's heart. Avoid smoking and walk as much as you can. During this time, the patient is monitored regularly by a home care nurse each week. See a doctor 8 to 10 weeks after a heart attack for a complete physical examination, including an EKG, exercise test, blood lipids, and chest radiographs. The rehabilitation program is usually long-term and at this stage it is necessary to follow the rehabilitation or refer the patient to educational and medical centers for more support and troubleshooting. No matter how seemingly safe the disease and its symptoms, the ground floor is still desirable for heart patients. As far as possible, heart patients should not live on crowded and noisy streets. You should avoid installing a loud alarm on the door of the house, which causes the patient to jump suddenly.
Original Article
Covid
Mahmoud Ali Hassan
Abstract
Shows the axis of the heart to propagate depolarization that extends into the heart to constrict the myocardium. In fact, the heart axis shows the direction in which most electrical stimuli move. When you read electrocardiograms, the heart axis indicates the direction of propagation of the stimulus. ...
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Shows the axis of the heart to propagate depolarization that extends into the heart to constrict the myocardium. In fact, the heart axis shows the direction in which most electrical stimuli move. When you read electrocardiograms, the heart axis indicates the direction of propagation of the stimulus. In addition, the direction of the heart axis indicates many disorders and changes in the heart. Usually at least two derivations are required to determine the axis. Algebraic sum is used to calculate the positive and negative of the QRS complex. For example, if the complex has a long R and a short S, count the number of cells occupied by R on the electrocardiogram paper vertically and count it as a positive digit, and count the number of negative cells as a negative digit. We put and then calculate its algebraic sum. If the biphasic complex is one and its size S and Rare exactly equal, the algebraic sum will be zero, which is why in this derivation the electric force is equal on both sides, so it is at the central point. But if the algebraic sum is a positive or negative numerical derivation, that is, the corresponding derivation line is deviated in the positive or negative direction. To determine the axis, it is usually best to see which of the 6 organ derivatives is biphasic, and then find the derivative perpendicular to it, the best lead being the AVF lead perpendicular to the D1 lead or the AVL lead perpendicular to the D2 lead and the AVR lead It is perpendicular to the D3 lead, the most common being the first. Examining an EKG will show that as the location of the positive electrode in the breast derivatives changes sequentially.
Original Article
Health
James Beki
Abstract
Junctional rhythm occurs when the junctional areas of the AV node become the heart pacemaker instead of the SA node. For example, when SA node activity is slow or AV junction automatics increase. Elusive junctional rhythm occurs if the AV junction discharge rate is between 40-60 times per minute and ...
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Junctional rhythm occurs when the junctional areas of the AV node become the heart pacemaker instead of the SA node. For example, when SA node activity is slow or AV junction automatics increase. Elusive junctional rhythm occurs if the AV junction discharge rate is between 40-60 times per minute and its causes include patient sinus syndrome, digitalis intoxication, lower MI, rheumatic heart disease and vagus nerve stimulation. Accelerated junction rhythm occurs when the junction rate is 60-100 beats per minute. Digital poisoning, hypokalemia, lower extremity MI heart problems and rheumatic heart disease. The presence of three premature beats of AV junction or more at a speed of 200-60 beats per minute is called junctional tachycardia and its possible causes include digitalis intoxication, ischemia or infarction of the lower or posterior myocardium, congenital heart disease in children and inflammation of the junction AV is after heart surgery.
