Journal of Surgery and Trauma
Volume:11 Issue: 3, Autumn 2023

Crohn's Disease (CD) is a chronic inflammatory bowel disease characterized by recurring symptoms that can result in bowel damage and long-term disability. It is crucial to achieve early diagnosis and appropriate treatment. Perianal manifestations are common in 20%-54% of Crohn's disease patients, with fistulas being the primary symptom in 10%. The presence of perianal Crohn's disease can occur before or after initial diagnosis and is associated with higher postoperative recurrence, surgical intervention, and shorter recurrence times. Other signs of severe disease include smoking, persistent symptoms, frequent flare-ups, emergence of lesions, steroid treatment, and surgery. Around 20% of patients have additional disease areas in the small bowel or ileocolic region (2). Perianal Crohn's disease significantly impacts patients' health and presents significant challenges for healthcare professionals. Perianal Crohn's disease, a common cause of perianal lesions, often presents as perirectal/perianal fistula, with over half of patients having multiple lesions. However, symptoms often lack correlation with objective assessment methods like endoscopy, cross-sectional imaging, or noninvasive biomarkers. Accurate evaluation of fistulae can be achieved through the use of Contrast-enhanced magnetic resonance imaging, endosonography, and examination under anesthesia (EUA). These methods enable the distinction between simple perianal fistulae and complex fistulae. Perianal CD fistulas can be simple or complex, with simple fistulas having a single external opening and low lesion. Individuals with CD are more likely to develop complex fistulizing disease, which presents significant treatment challenges.......

Anal fissure is one of the most painful diseases of the anus region. Diverse approaches for managing this condition have been examined, however, no unanimous approach has been achieved. The current study aimed to evaluate the efficacy of topical triamcinolone NN plus Vaseline zinc oxide and finger dilation versus triamcinolone NN alone to manage anal fissures.

 The current comparative cohort study has been conducted on 90 patients suffering from anal fissures. The group of topical Vaseline zinc oxide plus finger dilation (n=45) was prescribed to administer the blend of triamcinolone NN (1 cc) and Vaseline zinc oxide (2 cc) topically three times a day and to enter their little finger into the anus 18-20 times per day. Since the second week, they used the index finger. Topical triamcinolone NN only was administered by another group (n=45). The patients were weekly followed for three weeks and assessed pain severity using the Visual Analog Scale and bleeding incidence. The obtained data was analyzed by SPSS software (version 23). The Chi-square test, student t-test, and repeated measured ANOVA were used for data analysis. The P-value of less than 0.05 was defined as the level of significance.

Pain intensity (P =0.057) and bleeding (P =0.75) were similar in both groups at baseline, while the cases experienced significantly lower frequencies of bleeding in all follow-up visits (P <0.001). Pain severity was reduced significantly in cases within three weeks after the interventions (P-value<0.001) as well as the controls (P =0.021); however, the presented scores by the controls were significantly higher in all follow-up visits (P <0.001).

According to the findings of this study, the administration of topical Vaseline zinc oxide and daily anal sphincter self-massage can effectively lead to anal fissure symptoms control; however, further studies with a more prolonged period of follow-up are strongly recommended.

The appendix is a narrow, worm-shaped tube that separates from the inner wall of the cecum. The length of the appendix varies from 2 to 20 cm, but on average it is 9 cm and can be placed in different positions. It seems essential to determine common positions of the appendix in different populations to reduce the risk of complications associated with surgical treatment. The aim of this study was to evaluate the position of the appendix in appendectomy patients referred to the General Surgery department of Shohada-e-Ashayer Hospital, Khorramabad, Iran, from 2016 to 2019.

This was a retrospective cross-sectional study conducted on patients who underwent an appendectomy at Shohada-e-Ashayer Hospital, from 2016 to 2019. In this study, data including gender, age, appendix position, Body Mass Index (BMI), appendicitis pathology, and length of the appendix were collected from all patients referred to the hospital for an appendectomy. The collected information was entered into SPSS software (Version. 22) and analyzed using Chi-square and One-Way ANOVA tests at a 0.05 significance level.

This study was conducted on 222 appendectomy patients, of whom 128 patients (57.7%) were men and 94 (42.3%) were women. The mean age of the subjects was 28.32±14.84 years. The length of the appendix varied from 4.5 to 25 cm with an average length of 10.41±3.03cm. The most frequent position in the study population was the anterior position, which was observed in 112 subjects (50.45%), followed by the retro-cecal position in 95 (42.79%), and the para-cecal position in 15 patients (6.76%).

In our study population, the anterior position was the most common appendix orientation. Also, a relatively high frequency of retro-cecal position was observed.

The outbreak of the novel coronavirus disease 2019 has caused tremendous physical and psychological pressure on healthcare workers, particularly those working in departments that provide care for patients with coronavirus disease 2019 (COVID-19). This research aimed to assess the anxiety and depression levels among healthcare professionals working in operating theaters (anesthetic technicians and nurses) during the COVID-19 outbreak.

This is a cross-sectional and multi-center study was conducted from May to June 2021. The study population included 219 operating room personnel. Data were collected using the Hospital Anxiety and Depression Scale (HADS), Emotional functioning and global quality of life (EORTC QLQ-C30), and demographic characteristics. Statistical analysis was performed using the SPSS V. 19.0 independent-samples t-test, and Chi-square test. The p-value less than 0.05 is considered a significant level.

The findings of this study showed that the frequency of female participants was 133 (54.2%) and the participant's age was 32.15 ± 8.54. Also, the score range of anxiety (12.0-22.0) and depression (12.0-24.0) and mean ± SD score of anxiety and depression among 83 anesthesia nurses and 116 surgical technicians are respectively 17.07 ± 2.09 and 18.04 ± 2.37, based on the HADS questionnaire. Also, according to the EORTC QLQ‐C30 questionnaire, it is observed that there was no statistically significant difference between anesthesia nurses and operating room surgery technicians in the average score of anxiety (17.04 ± 2.05 vs. 17.12 ± 2.09, P = 0.78) and depression (17.87 ± 2.31 vs. 18.11 ± 2.43, P = 0.49). Moreover, According to our results, the level of anxiety and depression in our healthcare professionals working in operating theaters is so high (HADS scores ≥ 11) that is considered to be a significant “case” of psychological morbidity.

As a result, it can said that providing healthcare professionals with psychological support has a main role against depression and anxiety during pandemics, and it could help healthcare workers to manage the current situation. Therefore, psychological intervention and efficient resource consumption are desirable to relieve the special psychological effects of the pandemic. It is crucial to increase the observation and detection of early cases of depressive and anxiety symptoms to prevent disastrous events.

Head and neck skin cancers are the most frequent malignancies in Iran and across the globe. Skin malignancies are caused by a variety of risk factors, including sunshine and vitamin D deficiency. Despite the relatively high number of sunshine days per year in Southern Khorasan, there is insufficient research investigating skin malignancies in this province. This study aimed to characterize head skin (face/scalp) malignancies in patients admitted to the surgical ward at Imam Reza Hospital in Birjand between October 2016 and October 2020.

Ninety-nine patients with head skin cancers from Southern Khorasan province were recruited in this descriptive, cross-sectional study. The patients were diagnosed in the surgical ward of Imam Reza Hospital in Birjand from October 2016 to October 2020. The required data were collected using a checklist based on patients’ files, and the data were analyzed using the Chi-square and Fisher’s exact tests in SPSS software (Version. 16). The level of significance was set at P <0.05.

Patients with Basal cell carcinoma (BCC) and Squamous cell carcinoma (SCC) were on average 68 years and 74 years old, respectively. BCC (73.74%) was the most prevalent neoplasm, followed by SCC (23.23%) and melanoma (3.03%). The nose (28.1%), cheeks (27.1%), and scalp (19.8%) were the most frequent locations of involvement. In individuals with non-melanotic skin cancers, the mean lesion size was 12 mm in the BCC group and 23 mm in the SCC group.

BCC was the most common head and facial skin neoplasm. Participants did not differ significantly in terms of age and gender. The most common location of involvement was the nose. SCC lesions were significantly greater in size than non-melanotic lesions. Only one case of metastasis was found at hospital admission.

Environmental physical factors affecting the treatment process of patients generally include light and color of the environment, design of treatment centers, sound intensity, quality of temperature, and ventilation. The present study aims to identify the physical components of the architecture of medical environments and then explain the role of each in reducing patients' stress and making the health centers more efficient in Birjand.

This research was conducted based on a descriptive-analytical approach. The study population consisted of candidates for surgery at Razi Hospital and Imam Reza Hospital in Birjand in 2022. Using Cochran's formula, each group included 93 patients, resulting in a total participant size of 186 patients. Simple random sampling without replacement was employed as the sampling method. Data was collected using a research questionnaire. To analyze the impact of each of the physical components on the reduction of patients' stress, the Smart PLS3 software was utilized.

Two dimensions of physical and subjective components which themselves include social components of space and semantic components were extracted by reducing stress. It was found that in physical components with the coefficient of 0.579 and mental components with the coefficient of 0.515, respectively, had the greatest effect on reducing stress in patients.

The most important aspects of the research were found in sensory components, which include layout, light, sound, temperature, ventilation, and smell. Therefore, it is suggested to focus on the sensory components of space with the approach of reducing patient stress in medical centers.

Dear Editor,
We would like to thank you for the opportunity to respond to the issues raised in Kohan’s letter to the editor and to clarify aspects of our paper in relation to these concerns. We would also like to thank him for his interest in our paper and for taking the time to express their concerns. In his letter to the editor, Kohan notes potential concerns with the readiness for the Inter-Professional Learning Scale utilized in our study that is justified. Unfortunately, when translating the manuscript into English, the references were missing. The reference cut of the point is taken from the article of Vafadar. In relation to the reason for mentioning the surgery ward, it can be said that this article is a part of the National Agency for Strategic Research in Medical Education project, which was carried out due to the good cooperation of the staff and faculty members of the surgery ward during the COVID-19 pandemic. About the concern raised in the conclusion section, the results of Low's study (2009) entitled “Using workshops as a tool to deliver interprofessional learning” showed that the workshops had acted as a catalyst and impetus for further interprofessional learning and collaboration in practice so these workshops play an important role for the successful implementation of IPE. In relation to the concern raised in the recommendation section, it can be said there are explicit educational policy recommendations, funding, and curriculum development for IPE.