en
jalali
1395
4
1
gregorian
2016
7
1
4
3
online
1
fulltext
fa
The Effect of Dexamethasone in Reducing PropofolInjection Pain in 6 to 13-Year-Old Children Undergoing AdenotonsillectomySurgery: A Double-Blind Clinical Trial
Introduction: Propofol is a popular intravenous anesthetic and a quick inducer of anesthesia with quick recovery. However, its downside lies with pain and discomfort during intravenous injections when injected in small blood vessels in the back of the hand, which prevails in 85% of children. This study investigates the effect of Dexamethasone in reducing propofol injection pain in children.
Methods: In this double-blind clinical trial, 50 children aged from 6 to 13 years undergoing elective Adenotonsillectomy in Birjand-based Valiasr Hospital were randomly assigned into case and control groups. Intravenouscannulation was performed with intravenous cannula No. 22 on hands of all participants. Under similar conditions, 0.2 mg (oral) Midazolam as premedication and 20 ml of juice were administered for all the patients two hours before surgery. The same volume of Dexamethasone and normal saline (0.15 mg/Kg) was injected in the case and control groups, respectively. Immediately after, 20% of anesthesia induction dose of propofol (1%) was injected on all patients following which injection pain severity was measured using the Face Pain Scale (FPS) on a scale from 0 to 10. The remaining doses of propofol, Atracurium, and Fentanyl were subsequently injected whereby the anesthesia process was completed. The collected data were analyzed in SPSS-17 using t-test, Mann-Whitney, Fisher, and McNemar’s tests. The significance level was set at P<0.05.
Results: Half of the participants were female. Pain severity rates were 4.32±4.89 and 6.48±1.76 in case and control groups, respectively. The results showed that pain severity was significantly greater in the controls than the cases. Heart rate increased in both groups after intervention (p <0.001). In terms of drug injection complication, three cases were reported in the control group, while there was only one patient in the cases with a significant difference between the groups according to Fisher and McNemar tests.
Conclusions: Dexamethasone can be used as an effective and routine drug in the operating room to reduce propofol injection pain in children before the induction dose of propofol, hence increased satisfaction of children from anesthesia.
Propofol, Pain, Dexamethasone, Child, Tonsillectomy
33
37
http://jsurgery.bums.ac.ir/browse.php?a_code=A-10-66-2&slc_lang=en&sid=1
Seyyed Hassan
Karbasi
Associate Professor, Department of Anesthesiology, Faculty of Medicine, Birjand University of Medical Sciences, Birjand, Iran
shkarbasy@yahoo.com
0031947532846002091
0031947532846002091
No
Pooya
Derakhshan
Assistant Professor of Anesthesiology, Department of Anesthesiology, Iran University of Medical Sciences, Rasool akram Hospital, Tehran, Iran
pooyaderakh@yahoo.com
0031947532846002092
0031947532846002092
No
Hossein
Hashemi
Bachelor of Anesthesiology, Student Research Committee, Birjand University of Medical Sciences, Birjand, Iran
0031947532846002093
0031947532846002093
Yes
en
A comparative study on the effects of warm intravenous fluids, intravenous pethidine, and combined warm intravenous fluids and humid-warm oxygen on hemodynamic parameters after general anesthesia in patients with shivering in the recovery room
Introduction: Pethidine is commonly used to treat shivering after general anesthesia (GA), yet respiratory depression may subsequently occur. Warming methods such as warm fluids and/or humid-warm oxygen inhalation can reduce shivering after GA. This randomized clinical trial aimed to compare the effects of three different methods on the reduction of shivering and their hemodynamic and respiratory side-effects in patients undergoing abdominal surgery.
Methods: Eighty-seven patients undergoing abdominal surgery by GA were randomly assigned into three groups (two intervention groups versus the pethidine group). Patients in warmed intravenous fluids group received warmed ringer serum (38 °C). The patients in the combined warming group received warmed ringer serum (38 °C) and humid-warm oxygen, and patients in the pethidine group received intravenous pethidine only. The hemodynamic parameters of patients were collected and analyzed.
Results: The elapsed time of shivering in the warmed intravenous serum group, the combined warming group and the pethidine group were 7±1.5 min, 6±1.5 min, and 2.8±0.7 min, respectively, where the difference was statistically significant (P < 0.05). In the pethidine and combined warming groups, the pulse rate (PR) and systolic blood pressure (SBP) increased, whereas the diastolic blood pressure (DBP) decreased. As for the warmed intravenous serum group, pulse rate, DBP and SBP decreased (P >0.05). The mean respiratory rate (RR) decreased in the pethidine group (from 16 to 15). The mean RR increased (from 16.2 to 16.8) in the combined warming groups, and the differences were statistically significant (p<0.05).
Conclusions: The combined warming method reduces the shivering length, while the hemodynamic parameters (PR, BP) remain stable and respiratory depression does not occur. Therefore, it can be used to prevent hypothermia and reduce shivering after general anesthesia.
Anesthesia, Meperidine, Intravenous, Combined, Hemodynamic, Shivering
38
43
http://jsurgery.bums.ac.ir/browse.php?a_code=A-10-61-4&slc_lang=en&sid=1
Ayob
Akbari
Medical toxicology and Drug Abuse Research Center(MTDRC),Birjand University of Medical Sciences, Birjand, Iran.
Akbari Ayob @bums.ac.ir
0031947532846003165
0031947532846003165
No
Reza
Abdi
Assistant Professor of Orthopedics, Fellowship of Pediatric Orthopedics, Birjand University of Medical Science, Birjand, Iran
reza1352abdi@gmail.com
0031947532846003166
0031947532846003166
Yes
Somaye
Jomefourjan
Surgery and Trauma Research Center, Birjand University of Medical Sciences, Birjand, Iran
s.jomehforjan@gmail.com
0031947532846003167
0031947532846003167
No
Mojtaba
Gholami
MS in Nursing, Birjand University of Medical Sciences, Birjand, Iran
0031947532846003168
0031947532846003168
No
en
Effect of Avastin on intraocular pressure before and after intravitreal injections
Introduction: Intravitreal Avastin (bevacizumab) injection is reportedly accompanied by ocular and systemic side-effects. Our enquiry assesses whether there are any differences between intraocular pressure (IOP) in baseline and on the day after injection in patients treated for retinal disease.
Methods: In this experimental study, 82 eyes with retinal diseases that had indication for anti-VEGF and were treated with injections of intravitreal bevacizumab were taken as the case group, and 82 healthy eyes were considered as controls. The IOP was measured by non-contact tonometry in both the healthy eyes and the eyes with retinal diseases before and 24 hours after intervention. Data were analyzed by paired t test and independent t-test in SPSS 19.0 software. Significance level was set at P <0.05.
Results: Results of the study showed that the mean IOP before injection was not significantly different in either groups (p=0.51). However, it was significantly lower after injection than before it in both case and control eyes (p<0.01). The mean IOP changes before and after infusion in the case and control eyes did not differ significantly (p=0.30).
Conclusions: Our study did not find an increased IOP in bevacizumab-treated eyes when compared to fellow control eyes. Further studies with a greater sample size are needed to evaluate whether an increased number of ranibizumab injections is associated with IOP changes.
Bevacizumab, Intraocular pressure, Intravitreal Injections
44
46
http://jsurgery.bums.ac.ir/browse.php?a_code=A-10-72-1&slc_lang=en&sid=1
Behrooz
Heydari
Assistant Professor, Department of Ophthalmology, Faculty of Medicine, Birjand University of Medical Sciences, Birjand, Iran
hb51958@yahoo.com
0031947532846003286
0031947532846003286
Yes
Saeed Reza
Heydari
Department of Optometry, Faculty of Optometry, Mashhad University of Medical Science, Mashhad, Iran
heydarisr29@gmail.com
0031947532846003287
0031947532846003287
No
Gholamhossein
Yaghoobi
Professor, Department of Ophthalmology, Faculty of Medicine, Birjand University of Medical Sciences, Birjand, Iran
yaqubig@yahoo.com
0031947532846003288
0031947532846003288
No
en
A retrospective epidemiologic study on upper extremity tumors in Firozgar Hospital
Introduction: Epidemiologic data of upper extremity tumors are still few and sometimes conflicting. In our department, hand surgeons manage these tumors. Good documentation of patients’ information permitted us to make an epidemiologic study on the tumors of the upper extremity operated in our department.
Methods: We retrospectively studied all the cases of upper extremity tumors operated from 1992 to 2012. The required files were collected from the hospital’s databank and the pathology report from the registry of the department of histology.
Results: The mean age of patients was 37.91 years (from 3 to 83 years). The series included 100 patients (60 women and 40 men). Tumors concerned soft tissues in 78 cases (78%), bone in 18 cases (18%), and skin in 4 cases. Nearly all the malignant hand tumors were found in men (5 males, one female).
Conclusions: The data are comparable to other published studies. Upper extremity tumors are more prevalent in females (60%). The prevalence of bone tumors (18%) in our study is greater than other studies (from 1.6% to 11.4%) and the prevalence of skin tumors is lower (4%). Except for skin tumors where recruitment modalities are more variable, this series seems to be a good reflection of the prevalence of the different types of hand and wrist tumors.
Upper extremity, Bone tumor, Skin tumor, Osteosarcoma, Lipoma
47
50
http://jsurgery.bums.ac.ir/browse.php?a_code=A-11-92-1&slc_lang=en&sid=1
Seyed Hamzeh
Mousavie
Assistant Professor of General Surgery, Department of Surgery, Iran University of Medical Sciences, Rasool akram Hospital, Tehran, Iran
s.hamzah.mousavie@gmail.com
0031947532846003138
0031947532846003138
No
Shahram
Nazerani
Professor of General Surgery, Department of Surgery, Iran University of Medical Sciences, Rasool akram Hospital, Tehran, Iran
snazeranimd@gmail.com
0031947532846003139
0031947532846003139
Yes
Jalil Shoa
Alhasani
Department of Surgery, Iran University of Medical Sciences, Rasool akram Hospital, Tehran, Iran
jalil.shoa@gmai.com
0031947532846003140
0031947532846003140
No
Ali Reza
Negahi
Assistant Professor of General Surgery, Department of Surgery, Iran University of Medical Sciences, Rasool akram Hospital, Tehran, Iran
ar.negahi@gmail.com
0031947532846003141
0031947532846003141
No
Pooya
Derakhshan
Assistant Professor of Anesthesiology, Department of Anesthesiology, Iran University of Medical Sciences, Rasool akram Hospital, Tehran, Iran
pooyaderakh@yahoo.com
0031947532846003142
0031947532846003142
No
en
Associations between preoperative P-wave characteristics, C-reactive protein levels, and atrial fibrillation after coronary artery bypass graft surgery
Introduction: Atrial fibrillation (AF) is the most common complication of cardiac surgery which may cause remarkable morbidity and complications. Identifying predicting factors of this arrhythmia can help prophylactic therapy. The present study is designed to investigate the hypothesis that HsCRP level and P-wave characteristics are associated with the incidence of post-operative AF.
Methods: In this prospective study, 50 consecutive patients undergoing coronary artery bypass graft (CABG) operation during a 1-year period at Vali-e-asr Hospital, Birjand, Iran were enrolled. All the patients underwent electrocardiography (ECG) before surgery and P-wave duration and height were measured. In addition, blood samples were collected the day before surgery as well as 12, 24 and 72 hours after surgery to measure CRP serum levels. Patients were monitored after surgery to detect probable AF rhythm. Data was analyzed using SPSS 16.
Results: Of the 50 patients, 10 (20%) developed AF in the postoperative phase during days 1 to 5, while the other 40 patients (80%) had stable sinus rhythm. P-wave duration and height were significantly different in patients who subsequently developed postoperative AF with the mean values of 109.5±15.7 and 0.14±0.03, respectively. Mean HsCRP levels before and 12, 24, and 72 h after operation showed no significant difference.
Conclusions: Patients prone to AF arrhythmia can be identified by measuring P-wave duration and height in preoperative ECG. Hs.CRP levels before and after CABG surgery may not contribute to AF prediction.
Coronary Artery Bypass, Atrial Fibrillation, Electrocardiogram, C - reactive protein
51
57
http://jsurgery.bums.ac.ir/browse.php?a_code=A-10-122-1&slc_lang=en&sid=1
Nahid
Azdaki
Assistant Professor of Cardiology, Atherosclerosis and Coronary Artery Research Center, Birjand University of Medical Sciences, Birjand, Iran
nahidazdaki@yahoo.com
0031947532846002106
0031947532846002106
No
Navid
Ghodsi nik
Student of Medicine, Student Research Committee, Birjand University of Medical Sciences, Birjand, Iran
navid.ghodsi87@gmail.com
0031947532846002107
0031947532846002107
No
Navid
Rabiee
Student of Medicine, Student Research Committee, Birjand University of Medical Sciences, Birjand, Iran
navid_rabiee@yahoo.com
0031947532846002108
0031947532846002108
No
Mahmood
Zardast
Assistant Professor of Pathology, School of Medicine, Birjand University of Medical Sciences, Birjand, Iran
dr.zardast@yahoo.com
0031947532846002109
0031947532846002109
No
Amir
Rahmanian Sharifabad
Medical Doctor, Atherosclerosis and Coronary Artery Research Center, Birjand University of Medical Sciences, Birjand, Iran
rahmanian_amir@yahoo.com
0031947532846002110
0031947532846002110
No
Mahmood
Hosseinzadeh Maleki
Associate Professor of Cardiac Surgery, Atherosclerosis and Coronary Artery Research Center, Birjand University of Medical Sciences, Birjand, Iran
mahmoodhosseinzadeh@yahoo.com
0031947532846002111
0031947532846002111
Yes
Majid
Jafarnrzhad
Assistant Professor of Cardiology, Atherosclerosis and Coronary Artery Research Center, Birjand University of Medical Sciences, Birjand, Iran
m-jafarnejad@yahoo.com
0031947532846002112
0031947532846002112
No
en
Prevalence of parathyroid removal during total thyroidectomy in Rasoul Akram and Firozgar hospitals during 2013- 2014:
A case-series study
Introduction: It is not a routine to remove the parathyroid glands during thyroidectomy except when they are ischemic or have malignancy. In this study, the prevalence of parathyroid removal during total thyroidectomy was assessed.
Methods: In this case-series study, 53 consecutive patients under total thyroidectomy in two general hospitals during 2013-2014 were enrolled. Serum parathormone values of the patients were assessed, and radioactive iodine uptakes were studied to check for preserved parathyroid gland in the postoperative phase. The obtained data were analyzed in SPSS 14.0.
Results: This study incorporated fifty-three consecutive patients under total thyroidectomy who were treated in Rasoul Akram and Firozgar general hospitals from 2013 to 2014. Forty-six patients (86.8%) had no parathyroid removal and 13.2% had parathyroid removal. Four patients had intra-thyroidal parathyroid gland in permanent pathology.
Conclusions: One-eighth of the subjects under total thyroidectomy would experience parathyroid removal which would not be a significant contributor, indicating a low chance of parathyroid removal during total thyroidectomy.
Thyroidectomy, Parathyroidectomy, Thyroid, Parathyroid
58
61
http://jsurgery.bums.ac.ir/browse.php?a_code=A-10-92-2&slc_lang=en&sid=1
Mostafa
Hosseini
Associated Professor of General Surgery, Department of Surgery, Iran University of Medical Sciences, Rasool akram Hospital, Iran
md_mostafa_h@yahoo.com
0031947532846003173
0031947532846003173
No
Pooya
Derakhshan
Assistant Professor of Anesthesiology, Department of Anesthesiology, Iran University of Medical Sciences, Rasool akram Hospital, Iran
pooyaderakh@yahoo.com
0031947532846003174
0031947532846003174
No
Mohammad Ghasem
Kashanizadeh
Medical doctor, Tehran Azad Islamic University of Medical Sciences, Iran
28amirka28@gmail.com
0031947532846003175
0031947532846003175
No
Atefe
Kashanizadeh
General surgeon, Department of Surgery, Iran University of Medical Sciences, Rasool Akram Hospital, Iran
atefeka@gmail.com
0031947532846003176
0031947532846003176
Yes
en
A Miracle Survival after Falling from Height: A Case Report
Falling from height is an urban phenomenon and shows an important form of blunt trauma. We report an 18-year-old man who fell from 6 m height onto vertical steel rods in an under construction building. He went under surgery to remove two foreign bodies and was discharged on the 2nd day after surgery in good conditions. The objective of this report is to provide a definitive baseline to improve the incidence rate of fall from height. It is better to consult with key stakeholders in the workplace to gain a view on the key issues relating to fall from height. Similarly, it is good to use the available measurements in order to control and prevent those at risk.
Survive, Accidental Falls, Injury
62
64
http://jsurgery.bums.ac.ir/browse.php?a_code=A-10-121-1&slc_lang=en&sid=1
Mohammad
Aghebati
Department of General Surgery, Shiraz University of Medical Sciences, Shiraz, Iran
zghahreman@sums.ac.ir
0031947532846002122
0031947532846002122
No
Zahra
Ghahramani
Trauma Research Center, Shahid Rajaee (Emtiaz) Trauma Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
ghahreman2@yahoo.co.nz
0031947532846002123
0031947532846002123
Yes
en
Metastasis of alveolar soft part sarcoma of the retroperitoneum to distal phalanx of hand
Hand metastasis accounts for approximately 0.1 percent of all metastatic osseous malignancies. The lung, breast and kidney are the most common primary sources of these metastatic lesions.A rare case of retroperitoneal alveolar soft part sarcoma metastasizing to the distal phalanx of the second finger of the right hand is presented here. The patient underwent complete DIP amputation of the affected finger and was referred to oncologist for further therapeutic workups. Acrometastases run a poor prognosis; thus, palliative treatment is in the patient’s best interest.
Sarcoma, Alveolar Soft Part, Neoplasm Metastasis, Finger Phalanges
65
68
http://jsurgery.bums.ac.ir/browse.php?a_code=A-10-29-3&slc_lang=en&sid=1
Mohammadreza
Motie
Associate Professor of Surgery, Surgical Oncology Research Center, Imam Reza Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
MotieM@mums.ac.ir
0031947532846002119
0031947532846002119
Yes
Surgical Oncology Research Center, Imam Reza Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
Mohsen
Aliakbarian
Associate Professor of Surgery, Surgical Oncology Research Center, Imam Reza Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
mail:Aliakbarianm@mums.ac.ir
0031947532846002120
0031947532846002120
No
Alireza
Rezapanah
Assistant Professor of Surgery, Surgical Oncology Research Center, Imam Reza Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
Rezapanaha1@mums.ac.ir
0031947532846002121
0031947532846002121
No