Journal of Surgery and Trauma
Volume:4 Issue: 3, Autumn 2016

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.
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.
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.
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.

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.
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.
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).
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.

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.

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.
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.
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.
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.

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.
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.
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). 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 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.

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.
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 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 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.

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.
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 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 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.

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.