amir hossein pourdavood

Hemorrhoids can be managed by means of several therapeutic options. Regarding this, it is of fundamental importance to identify the hemorrhoidectomy method with fewer complications (e.g., bleeding, pain, and postoperative infections) or beneficial outcomes (e.g., accelerated speed of wound healing and resumption of normal life activities). Such knowledge can play a significant role in the advancement of medical and educational goals. Therefore, the present study was conducted to compare the clinical results of Milligan-Morgan surgery and hemorapy device in the treatment of patients with hemorrhoids.

This prospective study was conducted on 60 patients aged over 20 years with hemorrhoids referring to Bahonar and Afzalipour hospitals of Kerman, Iran, and diagnosed to need surgery by a surgical specialist. The study population was selected using a simple randomization method and then allocated into two groups of A and B, regardless of gender. Group A was operated by open or Milligan-Morgan technique, while group B was subjected to the hemorapy method. After the surgery, the patients’ data were recorded in specific forms and analyzed by SPSS software (version 21).

Out of 60 patients with hemorrhoids, 37 (64%) cases were male. Regarding the severity of hemorrhoids, 19 (32%) and 41 (68%) patients had fourth-degree and third-degree hemorrhoids, respectively. The mean age of the patients was 35.86±12.84 years. Four weeks after the surgery, the mean pain scores of the patients in the Milligan-Morgan and hemorapy groups were 3.67±1.84 and 1.67±1.35, respectively, showing a statistically significant difference (P=0.001). However, 8 weeks post-surgery, no pain, bleeding events, urinary retention, or incontinence were observed in the patients, except for anal stenosis in two patients treated with the Milligan-Morgan method.

According to the results, the hemorapy method resulted in lower postoperative pain than the Milligan-Morgan method. In addition, the hemorapy technique was accompanied by considerably fewer complications, such as bleeding, urinary retention, gas incontinence, and stenosis, compared to the Milligan-Morgan method. Consequently, the hemorapy method can be recommended for hemorrhoidectomy.

Malignant pleural effusion have significant impacts on patients live. This study was designed to determine the effect of Ethanolamine, Povidone-iodine, and talcum powder on pleurodesis in rats.

This experimental study was conducted in 36 adult male rats in Neuroscience Research Center affiliated to Kerman University of Medical Sciences, Iran 2018. The rats were randomly divided into four groups: Ethanolamine, Povidone-iodine, talcum Powder, and Salin (control group). The sclerosing agent was injected in each group. Then, microscopic and macroscopic effects of the drugs were compared. Data were analyzed applying Fisher’s exact test and multivariate analysis in SPSS.

The most severe fibrosis was seen in groups that had received Ethanolamine (85.6% severe fibrosis), while the group that received Povidone-iodine and talcum powder showed moderate fibrosis (61.5% and 38.5%, respectively). The rate of fibrosis was significantly higher in control group (72.7% mild fibrosis, P<0.001). Compared with the control group, more chronic inflammation was seen in the group that received Ethanolamine (P=0.004).

According to this study Ethanolamine and Povidone-iodine could be used as effective agents for inducing pleurodesis. Their low cost and availability make them good alternatives to other materials.

Methadone poisoning has become more common in the pediatric population due to extensive use of methadone maintenance therapy (MMT). It is associated with decreased level of consciousness, coma, respiratory distress and cardiac intoxication. The cardiac complications have been reported to be QT prolongation, torsade de pointes, coronary artery disease, arrhythmia, stress cardiomyopathy and death. We herein report two pediatric patients with accidental methadone poisoning who developed stress cardiomyopathy and cardiac failure. The first case was a 4-yaer-old girl and the second one was an 18-month-old girl both being accidentally poisoned with methadone syrup and were brought with decreased level of consciousness. Both were diagnosed to suffer from congestive heart failure based on echocardiography. However, the first case passed away despite appropriate treatment, while the second one survived the condition and was discharged with good condition and was symptom free at 6-month follow-up.

To determine the effects of pregnancy on the presentation, management, surgical and obstetrics outcome of patients with acute appendicitis.
This prospective cohort study was conducted during a 2-year period from 2014 to 2016 in Shahid Faghihi hospital of Shiraz University of Medical Sciences. We enrolled all the pregnant individuals with acute appendicitis who required surgical appendectomy. We also enrolled age-matched controls of non-pregnant women undergoing open appendectomy during the study period. The presentation, clinical and laboratory characteristics, surgical and obstetrics outcomes were determined in both study groups and were further compared between them. In order to determine the determinants of outcome, we also ran a multivariate logistic regression model.
Overall we included a total number of 584 patients with presumed appendicitis among whom there were 58 (9.94%) and 526 (90.06%) non-pregnant individuals. The pregnant patients had significantly longer duration of symptoms (p=0.038), lower temperature (p=0.026), longer duration of hospital stay (p=0.026) and higher rate of hospital admission longer than 2 days (p=0.031). The complications of the surgical procedure were comparable between the two study groups except for the pneumonia which was significantly higher in pregnant patient (p=0.041). After adjusting for confounders such as age and ethnicity, pregnancy remained significantly associated with lower temperature (p=0.018), longer symptom duration (p=0.042) and higher rate of pneumonia (p=0.049).
Acute appendicitis during the pregnancy was associated with longer duration of symptoms, lower body temperature and higher rate of pneumonia. The pregnancy and neonatal outcomes were comparable to the previously reported data.