Journal of

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A hydatid cyst is a zoonotic infection caused by the larval forms of mostly the Echinococcus granulosus. In humans, the most common site of cyst development is the liver (60%), followed by the lungs (20%), and much less commonly in other organs such as kidney, spleen, brain, and other soft tissues. The localization of cysts in muscles and subcutaneous is very rare. We report a case of 38-year-old female patient with a cystic shoulder mass turning out to be hydatid cyst on surgical exploration.

However, especially in non-endemic regions, the most diagnostic tool for an unusual presentation is the awareness of the physician. Surgical excision is the main modality of treatment. Also, complementary investigation to rule out other organs’ involvement is necessary. During surgical interventions, all precautions antiscolicidal solutions along with meticulous surgical techniques go a long way in the prevention of recurrence of this disease.

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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.

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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.

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• Introduction: Congenital heart defects (CHDs) are diagnosed in ≈8 to 10 per 1,000 live births in the United States. This study aimed to determine the outcomes in children with congenital heart disease.
• Methods: This cross-sectional descriptive-analytical study was conducted using the census method on all patients with a CHD who referred to the pediatric heart clinic in Valiasr Hospital, Birjand, Iran, and underwent heart operation during the desired period. The information contained in the patients' files was used to collect the required data. The rest of the information was gathered by calling the patients' parents. The collected data were analyzed in the SPSS-19 software using the Chi-square test and Fisher's exact test. The significant level was considered at the p-value of ≤ 0.05.
• Results: The results of the statistical analysis indicated that the type of intervention (i.e., operation, intrusion) had no statistically significant relationship with demographic indicators of gender, age by month, chromosomal abnormalities, the type of heart disease, and the development of children under-study; however, it showed a statistically significant relationship with the type of initial complaint. The rate of operation was significantly higher in the subjects, especially in those who had an initial complaint of murmurs. Based on the results, the age of children had a statistically significant relationship with the need for pacemakers and the amount of pleural effusion; these two outcomes increased significantly with the child's aging.
• Conclusion: A large number of demographic and clinical factors were effective in children's postoperative outcomes. Consequently, by conducting further studies at a wider level and controlling variables it is possible to compare the findings, achieve more favorable results, and improve clinical indicators.