Birjand University of Medical Sciences
Journal of Surgery and Trauma
2345-4873
6
1
2018
1
1
Effects of adding 5 mg meperidine to 10 mg bupivacaine for spinal anesthesia on postoperative pain in cesarean section surgery
1
5
EN
Samaneh
Kouzegaran
Department of Pediatrics, Birjand University of Medical Sciences, Birjand, Iran
Mahmood
Ganjifard
Department of Anesthesia, Birjand University of Medical Sciences, Birjand, Iran
Amir
Sabertanha
Department of Anesthesia, Birjand University of Medical Sciences, Birjand, Iran
Introduction: Meperidine has the advantages of being widely available and inexpensive. It would be highly cost-benefit if it is used at doses that are without any side-effect. Thus, this study aimed to assess the effect of meperidine 5 mg as an additive to bupivacaine for spinal anesthesia on postoperative pain in cesarean section surgery.
Methods: This double-blind randomized clinical trial was performed on 40 patients aged 20-40 yr. They were in classes 1 or 2 according to the American Society of Anesthesiologists (ASA) physical status classification system and were scheduled for elective cesarean surgery under spinal anesthesia. Patients were randomly allocated into two groups according to whether meperidine or normal saline was used as an additive to bupivacaine for spinal anesthesia. All patients with pre-existing or pregnancy-induced hypertension, known fetal abnormality or allergy to bupivacaine or meperidine were excluded. Postoperative analgesia was compared between the two groups immediately and 2, 12, 24 hours after surgery. Also, the need for antiemetic was compared between the groups. The collected data was analyzed in SPSS software (version 16) using independent t-test, Mann-Whitney, and Chi-square. The significance level for all tests was considered less than 0.05.
Results: The severity of postoperative pain 12 and 24 hours after surgery was significantly higher in normal saline group. There was no significant difference in incidence of pruritus, nausea and vomiting between the two groups.
Conclusions: Addition of meperidine 5 mg to intrathecal bupivacaine is associated with increased duration and quality of postoperative analgesia but has no significant effect on severity and incidence of pruritus, nausea and vomiting.
Birjand University of Medical Sciences
Journal of Surgery and Trauma
2345-4873
6
1
2018
1
1
Evaluation the effect of dexamethasone on post-dural puncture headache in cesarean surgery
6
10
EN
Fateme
Shakhsemampour
Department of Anesthesia, Faculty of Medicine, Birjand University of Medical Sciences, Birjand, Iran
Elahe
Allahyari
Department of Statistics, Birjand University of Medical Sciences, Birjand, Iran
Ali
Rajabpour-sanati
Department of Anesthesia, Faculty of Medicine, Birjand University of Medical Sciences, Birjand, Iran
Amir
Sabertanha
Department of Anesthesia, Faculty of Medicine, Birjand University of Medical Sciences, Birjand, Iran
Introduction: Inflammation is one of the probable causes of post-dural puncture headache (PDPH); logically, therefore, anti-inflammatory drugs such as dexamethasone can reduce the headache. The aim of this study was to evaluate the effect of intravenous dexamethasone 8 mg on PDPH in cesarean surgery.
Methods: This randomized double-blind clinical study was conducted on 104 patients aged from 15 to 45 years. They were in classes 1 or 2 according to the American Society of Anesthesiologists (ASA) physical status classification system and scheduled for elective cesarean section in Valiasr Hospital affiliated with Birjand University of Medical Sciences. The patients were allocated into one of two groups using simple randomization method. In one group, the patients received dexamethasone intravenously before anesthesia technique, while the other group received placebo. Spinal anesthesia using quince 25 needle with 0.5 percent 12-15 milligram bupivacaine was performed for patients in both groups. Forty-eight hours after the operation, the severity of headache was studied and recorded. The collected data were analyzed in SPSS-16 using independent t-test and Fisher’s exact test. The significance level was set at P <0.05.
Results: Analysis showed that dexamethasone could not significantly decrease the incidence of PDPH and severity of headache after spinal anesthesia in recovery and within 48 hours after surgery (P >0.05).
Conclusions: This study showed that dexamethasone did not have any beneficial effect in prevention of PDPH in cesarean surgery.
Birjand University of Medical Sciences
Journal of Surgery and Trauma
2345-4873
6
1
2018
1
1
The survey of Rrespiratory Rate, SPO2, nausea and vomiting in the use of three methods (warmed intravenous fluids, combined warming and pethidine) in patients with shivering
11
16
EN
Ayob
Akbari
Medical Toxicology and Drug Abuse Research Center (MTDRC), Birjand University of Medical Sciences, Birjand, Iran
Ahmad
Nasiri
Associated Professor, Medical Toxicology and Drug Abuse Research Center (MTDRC), Birjand University of Medical Sciences, Birjand, Iran
Mahdi
Heidari
Translator and Executive Expert, Deputy of Research and Technology, Birjand University of Medical Sciences, Birjand, Iran
Abdolakim
Ghasemi
Medical Toxicology and Drug Abuse Research Center (MTDRC), Birjand University of Medical Sciences, Birjand, Iran
Alireza
Amirabadizadeh
Medical Toxicology and Drug Abuse Research Center (MTDRC), Birjand University of Medical Sciences, Birjand, Iran
Ferydoon
Keramatinia
Medical Toxicology and Drug Abuse Research Center (MTDRC), Birjand University of Medical Sciences, Birjand, Iran
Introduction: Shivering after anaesthesia and surgery is a common complication. Different methods are used for control of shivering in the recovery room. The opioids such as pethidine are very common in shivering control. Pethidine can be induced apnea, respiratory depression and nausea &vomiting. The respiratory rate and spo2 can lead to more rapid diagnosis and treatment of serious hypoxemia and possibly avoid serious complication.The present study is a randomized clinical trial aimed to survey Rrespiratory Rate, SPO2, nausea and vomiting in the use of three methods(warmed intravenous fluids, combined warming and pethidine) in the abdominal surgery patients with shivering.
Methods: 87 patients in randomized clinical trial study with abdominal surgery by general anesthesia were assigned to three groups (two intervention groups in comparison with pethidine as routine) randomly. When patients meeting inclusion criteria were enrolled in the study, entered one of the three groups by simple Lottery. Patients in warmed intravenous fluids group received pre-warmed Ringer serum (38°C), patients in combined warming group received pre-warmed Ringer serum (38°C) accompanied by humid-warm oxygen, and patients in pethidine group received intravenous pethidine routinely. The Respiratory Rate and SPO2 of the participants were assessed for 20 min postoperatively in the recovery room. Then the collected data they were analyzed by chi-square, ANOVA, repeated ANOVA test, Kruskal–Wallis test, Wilcoxon test, Mann–Whitney U test, Tukey test, Friedman test, and repeated measurements through software SPSS (v. 18) with the significance level (P<0.05).
Results: The mean of SPO2 and RR in the pethidine group was decreased, spo2 from 98% to 97% and RR from 16 to 15. But those changes weren't statistically significant (p>0.05). In the combined warming groups the mean of SPO2 was clear increased from 96% to 98% and this change was statistically significant (p=0.031) but the mean of RR have no change. In the warmed intravenous serum group, the RR and SPO2 were slight decreased and weren't statistically significant (P >0.05). In the pethidine group 11% of patients have nausea& vomiting.
Conclusions: The pethidine induce apnea and respiratory depression. despite this effects and other side effects, the combined warming can be useful for shivering treatment.
Birjand University of Medical Sciences
Journal of Surgery and Trauma
2345-4873
6
1
2018
1
1
Age-standardized incidence of accidents and injuries: Western Iran from 2013 to 2015
17
21
EN
Moslem
Taheri Soodejani
Department of Biostatistics & Epidemiology, Faculty of Health, Kerman University of Medical Sciences, Kerman, Iran
Hossein
Fallahzadeh
Research Center Prevention and Epidemiology of Non-Communicable Diseases, School of Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
Mohammad
Tabatabaei
Faculty of Paramedical Science, Student Research Committee, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Azimeh
Ghaderi
Shahrekord Health Services Center, Shahrekord Universyy of Medical Science, Shahrekord, Iran
Introduction: Injuries are one of the most important causes of morbidity and mortality around the world. According to the World Health Organization, injuries from traffic accidents cause 5 million deaths and hurt millions of people across the world every year. In this study, we attempted to examine various injuries in different groups in Shahrekord city.
Methods: This is a retrospective descriptive study where data of accidents and injuries related to Shahrekord city during March 21, 2013, and March 20, 2015 (2 years in the Iranian calendar) were used. The obtained data were analyzed in SPSS software (version 16) using Fisher’s exact test at the significant level was considered 0.0.5.
Results: The age-standardized incidence for all accidents and injuries showed that the highest incidence, after traffic accidents (468 cases per 100,000 people), are related to falls (51 cases per 100,000 people) and violence (48 cases per 100,000 people).
Conclusions: Accidents and injuries occur more among younger age groups and this increases the burden of disease as well as the economic and psychological damages to society.
Birjand University of Medical Sciences
Journal of Surgery and Trauma
2345-4873
6
1
2018
1
1
Impact of abdominal radiography on surgical approach among patients with acute abdomen attending emergency ward
22
25
EN
Mostafa
Hoseini
Rasool Akram Hospital, Iran University of Medical Science, Tehran, Iran
Hamzeh
Mousavi
Rasool Akram Hospital, Iran University of Medical Science, Tehran, Iran
Nahid
Nafissi
Rasool Akram Hospital, Iran University of Medical Science, Tehran, Iran
Khashyar
Sanjary
Rasool Akram Hospital, Iran University of Medical Science, Tehran, Iran
Ali Reza
Negahi
Rasool Akram Hospital, Iran University of Medical Science, Tehran, Iran
Introduction: Abdominal radiography is an important method for acute abdomen cases and it is usually used to determine surgical approaches. This study was performed to determine the effect of abdominal radiography in the surgical approach among patients with acute abdomen attending the emergency ward of Rasool-Akram Hospital.
Methods: In this comparative cross-sectional study, 147 consecutive patients with acute abdomen attending the emergency ward of Rasool-Akram Hospital were enrolled. The effect of abdominal radiography on surgical approach was assessed in them.The collected data were analyzed in SPSS software (version 13) using independent t-test and Fisher’sexact test. The significance level for all tests was considered less than 0.05.
Results: In this study, radiography was effective on surgical approach in 63.3% of cases and it proposed peritonitis in 68% of cases. The impact was associated with lower age (P=0.0001), shorter surgery duration (P=0.003), and male sex (P=0.0001).
Conclusions: According to the results, it may be concluded that clinical assessment has a pivotal role for diagnosis of peritonitis, and if it is positive, no additional procedure is required whereby the operation should be carried out. Abdominal radiography should be used for cases with equivocal results in clinical assessment.
Birjand University of Medical Sciences
Journal of Surgery and Trauma
2345-4873
6
1
2018
1
1
A survey of postoperative antibiotic prescription in gastrointestinal cancers in the Tehran-based Firoozgar Hospital in 2014
26
29
EN
Mohammadreza
Zeinadini
Firoozgar Clinical Research and Development Center (FCRDC), Iran University of Medical Sciences (IUMS), Tehran, Iran
Seyede Fahmieh
Shojaee
Firoozgar Clinical Research and Development Center (FCRDC), Iran University of Medical Sciences (IUMS), Tehran, Iran
Mahdi
Alemrajabi
Firoozgar Clinical Research and Development Center (FCRDC), Iran University of Medical Sciences (IUMS), Tehran, Iran
Introduction: This study aims to present the pattern of antibiotics administration in Firoozgar Hospital as an example of how antibiotics are administered in Iranian hospitals. The pattern is compared with the proposed model in the literature and relevant guidelines to determine the extent to which errors are committed in this regard.
Methods: In this cross-sectional study, 72 cancer patients were recruited who underwent surgical procedures in Firoozgar hospital in 2014. A survey was made the amount, type, and duration of antibiotics taken by the subjects. Data were analyzed using SPSS software version 16 (SPSS, Chicago, IL, USA). The results for quantitative variables are expressed as mean and standard deviation (mean±SD) and for the qualitative variables are expressed as percentage. The comparison between quantitative variables was performed by ANOVA. The significance level (P-value) is considered to be less than 0.05.
Results: In laparoscopic surgeries, patients on average received 4 days of Ceftriaxone and 3 days of Metronidazole. After Whipple procedure, patients took 8 days of Ceftriaxone and 7 days of Metronidazole and in the open gastrectomy, the mean Metronidazole and Ceftriaxone consumption was 4 days. These numbers increased about 5 days for gastrectomy and if they took esophagostomy, Ceftriaxone for 5 days and Metronidazole for 3 days. The average number of hospitalization in laparoscopic procedures was 6 days; in the Whipple procedure, it was 16 days, and in gastrectomy operations, it was 9 days.
Conclusions: Comparing the long duration of hospital stay with the national protocols and the different antibiotic doses for various surgical procedures, further investigations could be conducted to switch the form of national protocols.
Birjand University of Medical Sciences
Journal of Surgery and Trauma
2345-4873
6
1
2018
1
1
The status of Clinical education in ophthalmology surgery ward of Vali-e-Asr Hospital affiliated with Birjand University of Medical Science before and after intervention
30
34
EN
Mohammad Hossein
Davari
Cardiovascular Disease Research Center, Birjand University of Medical Sciences, Birjand, Iran
Toba
Kazemi
Cardiovascular Disease Research Center, Birjand University of Medical Sciences, Birjand, Iran
Masoumeh
Saberhosseini
Medical D (GP) Cardiovascular Disease Research Center, Birjand University of Medical Sciences, Birjand, Iran
Introduction: Clinical education is one of most important medical education courses in Medicine. Medical education is in turn part of the higher education system that deals with human life, and thereby it is important to pay attention to its quantitative and qualitative aspects. In this study, we aimed to investigate the status of clinical education in ophthalmology ward of Vali-e-Asr Hospital in Birjand before and after an intervention.
Methods: This Descriptive-interventional study was conducted on students and interns in the ophthalmology department of Vali-e-Asr Hospital during one year. The number of participants was 30 (on average, 4-6 people per month). A questionnaire was first designed in 5 fields (Reviewing educational activities, studying the educational environment, reviewing patients' records, assessing the duties of trainees, and assessing the duties of interns). The questionnaires were later evaluated by 5 faculty members for validity, and after confirmation, the ophthalmology surgery ward was assessed in 3 months. Interventions were performed by the head and the deputy of the faculty of medicine. Eight months later, assessment was again carried out by the same researcher. The results were encoded and entered into SPSS 15 software and analyzed at the level of P ≤ 0.05 by independent t-test.
Results: After intervention in the field of educational activities, the score increased from 6 to 10 (P = 0.13). The educational environment score increased from 7 to 14 (P = 0.002). The mean score of assessments of interns before and after intervention was equal to 8. The mean scores for patients' records improved from 8.23 ± 1.98 to 8.92 ± 1.65 (P = 0.04).
Conclusions: The results of this study showed that physical changes in the educational spaces by the authorities can be easily accomplished and the educational environment can be improved by planning. It requires more action however to create changes in educational programs, improve the quality of clinical education, provide emergency training to students, and make plans by authorities.
Birjand University of Medical Sciences
Journal of Surgery and Trauma
2345-4873
6
1
2018
1
1
Early surgical and orthodontic treatment of a severely dilacerated maxillary central incisor: A case report
35
40
EN
Mahdjoube
Goldani Moghadam
Department of Orthodontics, Faculty of Dentistry, Birjand University of Medical Sciences, Birjand, Iran
Haniye
Kazemi
Faculty of Dentistry, Birjand University of Medical Sciences, Birjand, Iran
Mechanical trauma or developmental disorders can cause an eruptive problem mostly called dilaceration. The prognosis of a dilacerated tooth depends on early diagnosis and appropriate treatment planning. The case presented in this paper is an example of severe dilacerations of a maxillary central incisor which has been treated with early orthodontic intervention.