نشریه جراحی ایران
سال بیست و هفتم شماره 1 (بهار 1398)

Upper gastrointestinal bleeding (UGIB) is one of the most important medical emergencies that on time diagnosis and treatment of this event can reduce the mortality and improve the prognosis associated with it. UGIB can occur variceal or non-variceal, which variceal type is associated with liver disease, especially cirrhosis of the liver, and non-variceal cases associated with peptic ulcer disease. Non-variceal cases of upper gastrointestinal bleeding are diverse and at the top of them placed peptic ulcer disease, which has increased with increasing use of non-steroidal anti-inflammatory drugs, especially in the elderly. Early resuscitation, early endoscopy and surgery are the key points in the diagnosis, management and treatment of this condition. Today, various endoscopy techniques play a major role in the treatment of this disorder, and the role of surgery has been diminished. The purpose of this study is to review the management of non-variceal upper gastrointestinal bleeding.

Gastric cancer is one the most prevalent cancers around the world and is associated with low survival rates despite the advances in therapy modalities. This low rate of survival is mainly due to delayed seeking for treatment. Helicobacter pylori and HER2/neu gene overexpression are suggested as prognostic factors for gastric cancer. In this study, we evaluated the association of these two factors in gastric cancer.
Materials &

Fifty-nine patients with gastric cancer who had undergone gastrectomy in Shohda-Tajrish hospital during 2014 to 2015 were evaluated in this study. Histopathologic assessment of the samples was done and the frequencies of Helicobacter pylori positivity and HER2/neu overexpression were measured. The stage of gastric cancer was determined in patients. The data were analyzed with SPSS 20.0 and the associations of study parameters were investigated.

Mean age was 60.0 years. 74.6% of the study patients were male. 42.4% were positive for Helicobacter pylori. The status of HER2/neu membrane staining was as follows: 3+ (18.6%), 2+ (8.5%), 1+ (11.9%) and negative (61%). The most common stage was stage IV (47.5%). The association between Helicobacter pylori and HER2/neu expression was not significant (P > 0.05). The HER2/neu overexpression was correlated with disease stage and survival duration (P < 0.05).

Overall, there was a potential correlation between HER2/neu overexpression and lower survival in our study. There was no other significant association between parameters. Positive Helobacter pylori could not predict HER2/neu overexpression.

Hypospadiasis is a common congenital birth defect in which stopped normal developmental of urethra and prepose and chordee; there are various surgical procedures. This disorder, especially in severe cases, can cause disorder in urination and even sexual and mental disorders.

Since year 1396, 147 patients who underwent hypospadiasis repair operations have been evaluated for comorbidies, urethral place, chordee, type of repair, need cystostomy, skin Flap, mucosal Flap, glanoplasty and complications (hematoma, skin Flap necrosis, meatal stenosis, urinary fistula, rotation of penis) and need of re-operation.

The most common type of surgical procedures was MAGPI and TIP. The most common skin Flap was dorsal Flap 77 case (52.4%). Mucosal Flap 53 case (36.1%), glanoplasty 73 case (49.7%), tie over 16 case (10.9%), stent 21 case (14.3%), foley Catheter 51case (34.7%) and cystostomy 24 case (16.3%). Complication (hematoma 3 case (2%), skin Flap necrosis 3 case (2%), meatal stenosis 2case (1:4%), skin urinary fistula 2 case (1:4%), rotation of penis 2 case (1.4%) and no needs to re-operation is139case (94.6%).

By following the principles of Surgery, using the proper technique and use principles of creating Flap and correct use of foley catheter, stent… We can greatly reduce the complications of procedures. Our results were much better than other articles.

The Science is the product of curiosity, thought, reason, wisdom, and individual and group experiences, and all nations of the world are involved in its production. In recent years, the scientific output of various fields, including the field of surgery, has been evaluated and evaluated by various organizations and bases, including ISI and Scopus, within the ISC. Therefore, the results of these measurements can provide practical guidance for practitioners, writers, and scientific publications to reinforce their strengths. The purpose of this study was to compare and compare the production of Iranian surgical community science from 2000 to the end of 2017 using two Scopus and Web of Science citation databases.

The purpose of this study is applied and data collection is descriptive-survey which has been done by a scientometric approach. The statistical population of the study includes all scientific outputs of Iranian surgical researchers using Web of Science and Scopus Citation databases during 2000-2017. The method was done by limiting the keyword Surgery to Topic and restricting it to Iran. Also, using the embedded analysis engine option on the database and downloading and saving the data in Tab Limited format and transferring it to Excel software, the analysis related to each of the research questions was performed and the tables and charts were plotted.

The results of the study showed that Hashemi was recognized by producing 95 records on the Web site and 132 records in the Scopus base of the field's superior researcher. Tehran University of Medical Sciences also has the highest production in both of the most prominent organizations in the field of surgery. The review of journals showed that the Iranian Red Crescent Medical Journal published 177 records on the Web site of the Journal of Isfahan Medical School with 304 records in the Scopus database of the leading surgeons. The Iranian researchers in the field of surgery have published their products on the website of the US Department of Medicine on "general internal medicine" and on the scopus site "medicine". Other studies of the present study have identified the countries of Iran's collaborative scientific productions in the field of surgery, which showed that Iranian researchers conducted their most scientific productions at both sites with researchers from the United States, Canada and the United Kingdom.

The results showed that the process of dissemination of surgical field products in two bases is increasing. Also the leading authors in the two bases are in the first to third rank, although their number is different in both bases. The results also showed that researchers at the two sites publish their scientific products in different journals and did not confine their scientific productions to specific journals.

The increasing prevalence of obesity may lead to the significant negative health consequences. The current study aims to explore the effect of short-term
cognitive-behavioral therapy on obesity and its related consequences.

The present study used the pre-test-post-test experimental designed with a control group. The study population consisted of clients who have the BMI larger than 30 and referred to general and cosmetic surgeons for abdominal cosmetic surgery in Esfahan, Iran. Thirty clients who met the inclusion criteria were selected using the convenience sampling method and randomly assigned to intervention and control groups. The BMI, waist and hip circumferences, and self-esteem were measured using scales and meters and Rosenberg's self-esteem scale, respectively.

The results showed that cognitive-behavioral therapy had a significant effect on BMI and self-esteem. However, this effect was not significant in reducing sizes of waist and hip circumferences.

The short-term cognitive-behavioral therapy can be considered as an appropriate and cost-effective treatment for people with obesity leading to increase the clients' self-esteem.

Laparoscopic management of diseases is nowadays accepted in the international community and can be considered as one of the most common methods of abdominal surgery and standard treatment of gallstone as well as Cholecystitis. However, postoperative pain, one of the most common causes of delayed release after surgery, is a complex, multifactorial experience and an unpleasant sensory and emotional experience that is still one of the most serious problems for physicians and patients undergoing surgery that should be managed with injection of proper drugs to impose the least side effects possible on patients. The purpose of this study was to compare diclofenac and tramadol effect on postoperative pain relief and reduced side effects in patients undergoing laparoscopic cholecystectomy.

This is a randomized double blind clinical trial study. In this study, 61 patients who were Laparoscopic Cholecystectomy candidates were randomly divided into two groups of 31 and 30. The first group received 75 mg/kg diclofenac (N = 31) and the second one 100 mg/kg tramadol
(N = 30) as intravenous injection every 6 hours. Postoperative pain assessment was performed using VAS (Visual Analogue Scale) System at 6, 12, 18, 24 hours and their pain was evaluated. In case of pain, patients were given meperidine and finally dosage of meperidine was measured and recorded. After collection, data were encoded and entered into SPSS 18 software. Then, the data were analyzed using analytical statistical methods such as T-test and Chi-square. Significance level was set below 0.05.

24 hours after laparoscopic cholecystectomy, the mean prevalence of nausea in the diclofenac recipient group was significantly lower than the tramadol recipient group (P = 0.013). The mean prevalence of vomiting in the diclofenac group was significantly lower than that of the tramadol group
(P = 0.011). The mean prevalence of gastritis in the tramadol recipient group was significantly lower than the diclofenac recipient group (P = 0.006). Mean pain intensity in the tramadol group was significantly lower than the diclofenac group (P = 0.010). There was no other statistically significant difference between the two groups.

The pain after laparoscopic cholecystectomy is a common one that can be managed with injection of proper drugs to impose the least side effects possible on patients. The gold standard in postoperative pain management is the use of opiate medications; however, its use is limited due to side effects. Therefore, the present study concludes that intravenous tramadol is a more effective option than diclofenac for pain relief and will lead to a more comfortable postoperative period. However, it is worth noting that tramadol has a higher incidence of side effects than diclofenac, necessitating the opinion of attending physician for the injection of this drug according to patients’ condition.

Rhinoplasty is one of the most common cosmetic surgeries in Iran increasing in number daily. Studies have shown that psychological factors influence people's tendency to cosmetic surgery. The present study aimed to compare body image, self-esteem, and mental health indices between cosmetic surgery applicants and non-applicants in women referred to two Kermanshah cosmetic surgery centers in 2018-2019.
Materials &

This is a descriptive-analytical cross-sectional study performed on a sample of 64 women in two Kermanshah cosmetic surgery centers including a private clinic and Taleghani hospital in 2018-2019. In this study, 32 applicants for rhinoplasty were compared with 32 non-applicants. Data were collected using the multidimensional body-self relations questionnaire (MBSRQ) developed by Cash (1997), the Cooper-Smith Self-esteem Questionnaire (1967) and the General Health Questionnaire (GHQ-28) developed by Goldberg and Miller (1997). The gathered data were analyzed using SPPSS-16 software and descriptive and inferential statistics of independent t groups and multivariate analysis of covariance (MANCOVA). Significance level in this study was considered less than 0.05.

The mean score of mental health in the applicant group was 28.56 ± 06.14 higher than the non-applicant group (96.49 ± 63.10) (P = 0.22, T = 0.22) and among the mental health subscales, only depression showed a significant difference between the two groups (P = 0.003). Mean score of depression was 53.13 ± 48.5 in the applicant group and 09.10 ± 15.3 in the
non-applicant group. The mean total score of self-esteem did not differ significantly between the two groups (P = 0.22). Among the subscales of self-esteem, only the variables of family
self-esteem (mean score of applicant group = 34.4±38.1 and mean score of non-applicant group=18.5 ±06.1, P = 0.008) and social self-esteem (mean score of applicant group = 90.3±30.1 and mean score of non-applicant group = 68.4 ± 96, P = 0.008) showed significant difference between two groups. Also, body image and its subscales were not significantly different between the two groups (P > 0.05).

According to the results of this study, depression and low family and social self-esteem can lead to cosmetic surgeries, thus using effective interventions in this field, unnecessary cosmetic surgeries can be prevented.

Lymphoscintigraphy has been recognized as the modality of choice for lymph node staging of breast cancer patients. After intradermal injection of radiotracer, visualization of one or more sentinel lymph nodes in the axillary region and sometimes lymphatic vessels is expected. We report two cases of breast cancer who were referred to the nuclear medicine department for sentinel lymph node mapping before surgery. Unexpectedly, diffuse distribution of radiotracer and dermal backflow appearance was found. At final histology lymph node involvement and lymphatic vessels invasion was confirmed.

The new achievements in developing advanced material have caused new scopes of different kinds of carbon to emerge. In the late 1960s, the cooperation between Bokers and Vincent Gott caused the development of carbon pirolite. The use of carbon pirolite in the artificial hearts valve has compatibility with blood and good resistance against erosion, so it replaced the metallic materials. In 1990, a new pirolite carbon sample called ON-X was invented. Carbon has several Alotropic forms and is much similar to crystalline structure. This carbon is produced as a result of heat decomposition of hydrocarbon materials. LTI carbon is 25 times tougher that Alumina. LTI carbon has a good collection of properties including blood compatibility, physical and mechanical properties and good resistance and is one successful biomaterials. From the crystality point of view at the beginning of fatigue crack which mostly occurs in metals, does not happen in LTI carbon. If carbon components of hearts valve are designed properly and no external damage has been made on them, will not be fatigued. Only 60 cases out of 4 million implants have failed. Therefore the failure or fatigue of this material is negligible.

The responsibility of the surgeon to compensate the surgeon for the disease that has undergone surgery is one of the most controversial issues in the world of law and medicine that is of particular interest worldwide. Medical professionals are punished for seeing this dangerous specialist attractive, punishing important components. One of the responsibilities of physicians that occurs as a result of medical error is the responsibility of compensating the patient for surgery. Of course, there is no concern about this with liability insurance, but the principle of responsibility is considerable. One of the most neglected issues in the field of medical law is the relation between the doctor’s conviction and his civil liability. Accordingly, the purpose of this study is to examine the legal and corporate responsibilities and their relationship with each other. We will also discuss the terms of the surgeon physicians liability, related legal materials, ways of proving the surgeons liability, and compare civil and law enforcement liability.