فهرست مطالب

Journal of Surgery and Trauma
Volume:5 Issue: 1, Autumn 2017

  • تاریخ انتشار: 1396/04/18
  • تعداد عناوین: 8
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  • Mahmoud Ganjifard, Mahmoud Jafari, Hassan Karbasi Pages 1-6
    Introduction
    One of the complications of laryngoscopy and endotracheal intubation is sympathetic stimulation with hemodynamic changes that are always tried to be avoided by anesthesiologists. The aim of this study is to review and compare hemodynamic changes caused by both conventional and video laryngoscopy.
    Methods
    In this clinical trial performed in 2015 in the Birjand-based Imam Reza Hospital, a total of 42 patients were enrolled by census, 21 patients were intubated by direct laryngoscopy and 21 using video laryngoscope. The mean arterial blood pressure, systolic and diastolic blood pressure, pulse rate, and arterial oxygen saturation 2 minutes after induction and after intubation were checked. The data were subsequently analyzed in SPSS software (version 22) using independent T-test and Chi-square. The significant level was set at P
    Results
    According to the findings in this study, the average score of systolic blood pressure after direct intubation was significantly higher than intubation by glidescopy (139.00±22.47 versus 90.00±16.89). The mean arterial blood pressure after intubation by glidescopy was 96.34±13.16 and in direct laryngoscopy, it was 101.60±15.53 with no significant difference between the two. The mean heart rate in the glidescopy group was 104.86±15.79 and in the laryngoscopy group, it was 104.48±16.37, which is not significantly different between the groups.
    Conclusions
    Compared with video laryngoscopy, the direct laryngoscopy can significantly increase the mean systolic arterial blood pressure in patients, which can lead to fatal complications. Therefore, it is advisable to use glidescopy technique for intubation in high-risk patients.
    Keywords: Hemodynamics, Intubation, Laryngoscopy, Surgery
  • Seyed Ziaoldin Rasihashemi, Ali Ramouz Pages 7-12
    Introduction
    Application of Talc powder, Bleomycin and Tetracycline is among conventional treatments in recurrent malignant pleural effusion caused by malignant pleurodesis. The aim of this research is to estimate the effect and safety in application of betadine as a cheap and available chemical factor in treatment of pleurodesis.
    Methods
    In this empirical before-after study, all patients suffering from recurrent pleural effusion, who were admitted in the thoracic surgery department because of malignant nature of the diseases in a period of one year, were incorporated in the study. To perform pleurodesis, chest tube was initially inserted in the duration of 24-48 hours. Thereafter, 20 ml iodopovidon, 10 ml lidocaine, 80 ml normal saline of liquids were injected into the pleural cavity by a chest tube. All the patients were examined for the pleural effusion and pleurodesis recurrence monthly for 6 months. Chi-square and Fisher exact test were used as the qualitative and independent parameters in the quantitative comparison in this study.
    Results
    In this study, a total number of patients was 50 among whom 23 were male (46%) and 27 were female (54%). The mean age of the patients was 53.25±12.49 years. In the six months follow-up, 40 patients (80%) were completely recovered and the recurrence of the pleural effusion was noticed in 10 patients (20%). Comparison of the success rate of recovery in terms of the gender of the patients showed no significant relation between gender and response to the recovery process (P=0.219). Of the total of 32 patients (64%) with chest pain after pleurodesis, 23 patients had complete recovery, and the incidence of chest pain in patients with no improvement was significantly higher (P=0.018). However, there was no significant relationship between the severity of pain and the success of the treatment (P=0.92).
    Conclusions
    Compared with other sclerosant chemical substances, Iodopovidone is more cheaply available, is of high efficacy, and can be a good choice in treatment of malignant pleural effusion.
    Keywords: Neoplasm, Metastasis, Pleurodesis, Pleural Effusion
  • Ahmad Amouzeshi, Mahtab Dolatabadi, Samaneh Nakhaee, Mahmood Hosseinzadeh Maleki, Omid Mehrpour Pages 13-17
    Introduction
    Opium addiction is a social and health problem in many parts of the world, including Iran. The exact effects of this substance on the cardiovascular system and postoperative complications are not clear And the results of studies in this regard are also contradictory, Therefore, the present study aims to compare short-term mortality After coronary artery bypass surgery In two groups Opium consumer And non-consumer was done.
    Methods
    This cross-sectional study was performed on 194 patients who were hospitalized during September 2013 to September 2015 In Valiasr Hospital of Birjand, they were under CABG operations conducted. In this study, short-term mortality)Hospital and a month After discharge) Through existing records And phone calls were reviewed. All data were analyzed by SPSS 22 software and analyzed using descriptive and inferential statistics.
    Results
    Of the 194 patients who had undergone surgery twenty-three patients (12.2%) used opioid Among them, In the form of Inhaler, 13 patients (56.5%) orally And 3 patients (13%) was a combination of orally and inhaled. In general, there is a case of mortality during surgery And 7 cases (77.77%) of mortality occurred in the Hospital ward. During the one month follow up, There was a death case. Among the non-addicted patients164 case were alive and 7 died And among addicted patients as well 22 cases were alive And there was a death case. Finally, the results showed, No statistically significant difference between the mortality after surgery, Blood lipids, and diabetes, In two groups Opium consumer And non-consume(p>0/05). But hypertension in the non-addicted group was significantly higher (p
    Conclusions
    Based on the results of this study, there was no significant relationship between opioid dependence and short-term mortality in patients after CABG surgery. Due to low sample size and cross-sectional study, The design of cognitive studies with higher sample sizes seems to be necessary in order to discover causal relationships.
    Keywords: Opium, Dependency, Coronary Artery Bypass, Mortality
  • Saeed Safari, Mahdi Alamrajabi, Jalal Vahedian Ardakani, Masoud Baghaei, Farhad Zamani, Mohammad Hossein Sobhkhizi Pages 18-23
    Introduction
    Gallbladder removal surgery is performed in two ways: open, or laparoscopic. Compared with open surgery, laparoscopic surgery has a shorter admission period, less cost of treatment, and the patient’s faster return to work and daily activities. This study aims to investigate the effect of the disorder of transaminase enzymes before surgery on laparoscopic cholecystectomy outcomes.
    Methods
    The present study is a cross-sectional analysis conducted during the period of 2015-2016 on all patients with a diagnosis of acute cholecystitis admitted to the surgical ward of Firoozgar Hospital in Tehran. These patients, based on the level of disorder of the alanine aminotransferase (ALT) and aspartate aminotransferase (AST) enzymes, were divided into two groups: enzymatic disorder less than 2 times normal and normal, and enzymatic disorder higher than 2 times normal up to a maximum of 10 times normal. Data were collected by the researcher using a checklist containing the variables under study and analyzed in SPSS-22.
    Results
    The results of the study showed that of 89 patients with acute cholecystitis, 59.6% were female and the rest were male. The mean and standard deviation of the age of the patients was 48.6 ± 18.71. The analytical results showed that there was no significant relationship between elevated liver enzymes SAT and ALT and variables such as incidence of hemorrhage during surgery, change of surgical method (laparoscopic to open), surgical difficulty report by the surgeon, changes in anesthesia after surgery, and duration of hospitalization (P >0.05).
    Conclusions
    The results of this study showed that laparoscopy is possible for acute cholecystitis, even with the presence of elevated liver enzymes, and it depends largely on the experience of the surgeon and the anatomy of biliary duct.
    Keywords: Laparoscopic, Collosectomy, Cross-sectional Study, ALT, AST, Iran
  • Habibollah Rezaei, Shahram Shayan, Zahra Amouzeshi, Amrollah Roozbehi, Jafar Nikbakht, Bahareh Bahmanbijari, Amin Beigzadeh Pages 24-30
    Introduction
    The health system development plan is currently one of the most fundamental changes in Iran. The purpose of this study was to determine the amount of attention to the components of change in health Development plan from the Viewpoint of staff in Al-Zahra hospital in Isfahan and Afzalipour hospital in Kerman in 2015.
    Methods
    In this quasi-experimental study , the staff of Al-Zahra hospital in Isfahan and Afzalipour hospital in Kerman were selected by convenience sampling method. Data were collected using a researcher-made questionnaire and its validity and reliability were taken into account. Data were analyzed by SPSS version 21 and two-way multivariate analysis of covariance was used as appropriate at a significant level of p
    Results
    The average rate of attention to the components of change in three factors namely "support and planning", "training and counseling", and efficiency" Were respectively 3.93±0.63, 2.91±0.86 and 2.3±0.69. The overall mean of attention to change components was 2.83±2.52.
    Conclusions
    The mean of the total score showed that less attention has been paid to the components of change in the Health Development Plan. We suggest conducting a national survey to identify faulty components and elements in order to take corrective measures.
    Keywords: Change, Health development, Viewpoint, Staff
  • Somaye Jomefourjan, Seyed Yoosef Javadmoosavi, Ayob Akbari, Saeede Khosravi Bizhaem, Forod Salehi Pages 31-35
    Introduction
    Congenital cardiac abnormalities are among the problems that affect the quality of life of children and parents, especially the mothers. Meanwhile, mothers are severely stressed and harmed due to their emotions and feelings, so that the suffering can reduce their quality of life. This study aimed to compare the quality of life of mothers of healthy children and mothers of children with congenital heart disease after cardiac surgery.
    Methods
    This is a cross-sectional descriptive-analytic study where 100 mothers of healthy children and 60 mothers of children with congenital heart disease referring to Vali-e-Asr Hospital in 2016 and 2017 were incorporated. The mother's quality of life was assessed using the World Health Organization Quality of Life Scale (WHOQOL-BREF). The collected data was analyzed in SPSS software (version 22) using independent t-test, Mann-Whitney, Kruskal-Wallis and Chi-square. The significance level for all tests was considered less than 0.05.
    Results
    According to the findings, the mean age of mothers with healthy children was 31.91 ± 8.57 years and that of mothers of children with congenital heart disease was 32.48 ± 6.46 years. The mean score of the quality of life of mothers with healthy children was 71.25 ± 16.43 and that of the second group was 66.51 ± 15.46. The mean scores of social relationships, mental health, and physical health in mothers with healthy children were significantly higher than those of mothers after their child's surgery. However, there was no significant difference between the two groups as for the mean score of overall quality of life and environmental health.
    Conclusions
    According to the results, it was found that the quality of life of the mothers with unhealthy children is lower than that of mothers with healthy children. Therefore, proper training and timely counseling are recommended as potential measures to somewhat improve their quality of life.
    Keywords: Quality of life, Operation, Congenital heart disease, Mothers, Postoperative
  • Seyyed Abbas Hosseinirad, Gholamhossein Yaghoubi, Behrouz Haidari Pages 36-38
    Leeches are segmented worms belonging to Phylum Annelida and make up the subclass Hirudinea. Leeches have been historically used in medicine to suck blood from patients. Ocular infestation with leech is rare, moreover it is often misdiagnosed. In this report, we describe 2 patients with continuous bright ocular bleeding after swimming in a pool, and pseudo iris prolapse in a child after trauma with a wooden piece who immediately washed his face in a stream. Ocular leech infestation must be ruled out in children with a history of contamination or swimming in rural pool or streams.
    Keywords: Ocular, Infection, Leeches
  • Jalal Ahmadi, Abbas Hosseinirad, Hoda Dadgar, Mahmoud Ganjifard Pages 39-42
    The case is a 2-year-old previously healthy girl with coincidental penetrating eye and brain injury. A metal rod was inserted into the skull through the upper border of the right globe. After admission and diagnostic and surgical approaches, the rod was removed under general anesthesia, and no brain hematoma or ocular and significant periocular injuries were detected. No neurologic and ophthalmologic signs and symptoms were observed during hospitalization, and follow-up brain CT was normal.
    Keywords: Penetrating cranial injury, Penetrating eye injury, Eye foreign body