Journal of Surgery and Trauma
Volume:8 Issue: 2, Summer 2020

Dear Editor-in-Chief: Congenital structural heart diseases are the most commonly reported fatal anomalies in children. These anatomical disorders often can be corrected surgically .Today, echocardiography is the best and most important diagnostic technique for anatomical abnormalities in the heart. In this method, by using the ultrasound waves (sonography), anatomical details, and hemodynamic examination of the heart can be determined . Most pediatric cardiologists provide echocardiographic reports in the form of handwriting or typed text. This method of reporting is sometimes unable to understand the structural anomalies precisely and accurately for the final decision. Nowadays, 2-dimensional echocardiography is acceptable for the diagnosis of some structural heart abnormalities accurately. Even there is no necessary to angiography for surgical planning .2 But sometimes lack matching echocardiographic findings with surgical reports, it seems that adding a schematic figure base on echocardiography findings from the viewpoint of pediatric cardiologist will be the helper to the congenital cardiac surgeon. This proposed method of reporting will lead to the promotion of surgical treatment in congenital heart diseases. The history of the schematic picture in the anatomical textbook for a better understanding of subjects and also diseases has been shown previously by famous painters like Leonardo Davin chi. This suggestion shows that mapping can be viewed as a common language for better understanding of echocardiographic reports and more adaptation between comments of a pediatric cardiologist with designing congenital cardiac surgeon for more precise and complete treatment.

Since the laparoscopic cholecystectomy was introduced first in 1990, the 4-port laparoscopic cholecystectomy was the gold standard. The 4-port (lateral) is used to hold gallbladder fundus and observe Calot's triangle. It is discussed that the 4-port technique is not required in many patients. Therefore, this study aimed to make a comparison between 3-port and 4-port laparoscopic cholecystectomy methods in the treatment of gallstone disease.

A double-blind clinical trial was performed on patients admitted to Imam Reza Hospital, Birjand, Iran. The patients with gallstone disease (n=60) were randomly assigned into the case (3-port) and control (4-port) groups using balanced block randomization and underwent 3- or 4-port laparoscopic cholecystectomy. Postoperative pain was measured by a visual analog scale four h after surgery. The amount of pain-killer, duration of surgery, as well as length of stay and scars were measured in this study. Data were analyzed statistically in SPSS software (version 18) through the Chi-square test and t-test. A p-value less than 0.05 was considered statistically significant.

The groups were compared in terms of demographic characteristics. There were 24 females (80%) and 6 males (20%) in the control group and 25 females (83.4%) and 5 males (16.7%) in the case group (P=0.739). Moreover, the mean ages of the control and case groups were 59.823±7.8 and 61.10±4.7, respectively, and there was no significant difference between the groups in this regard (P=0.348). Furthermore, length of operation (P=0.001) and analgesic consumption (P=0.001) in the 3-port laparoscopic cholecystectomy group were lower than those in the 4-port group; however, the hospital stay (P=0.896) was the same in both groups.

The 3-port laparoscopic cholecystectomy is a safe, reliable, and cost-effective method in patients who underwent laparoscopic cholecystectomy.

Aging undoubtedly is associated with organ function failure and affects medical/surgical treatments. Free radicals are considered as one of the most common causes of senescence. Liver damage frequently occurs by advance age. Cinnamon (Cinnamomum zeylanicum) is one of the well-known spices in the world tend its antioxidant and hepatoprotective effects have been approved. This study aimed to evaluate the effect of cinnamon consumption on the recovery of partial hepatectomy.

 In this experimental study, thirty-two male Sprague-Dawley rats (57 weeks) randomly divided into two equal groups; control (normal diet) and cinnamon (received diet with 1% cinnamon by weight) for 45 weeks. Then, partial hepatectomy (30% of total liver weight) was performed.  (Blood collection and weighting were performed prior to hepatectomy and on the 2nd, 10th, and 28th days after the operation. The concentrations of nitric oxide metabolites (NOx), malondialdehyde (MDA), insulin, and glucose were assayed in serum.

The results showed that cinnamon consumption prevented postoperative weight loss. The cinnamon was significantly lowered serum MDA concentration 48 hours after hepatectomy as well as it significantly decreased weight loss due to partial hepatectomy on 2nd day after surgery. Change in serum NOx (% of no surgery animals) was dramatically increased following cinnamon consumption on the 2nd and 28th days after surgery. However, cinnamon did not affect serum glucose and insulin concentration.

cinnamon improved postoperative outcomes after hepatic resection in rats by attenuation oxidative stress as well as nitric oxide content. It might be considered as a useful dietary recommendation for elderly patients with hepatic resection.

Self-immolation is a deadly and painful issue that incurs high costs socially and individually. People who self-immolatearehardly cured and they will undergo serious mental and physical complications. This study aimed to determine the epidemiological distribution of self-immolated patients referring to Velayat Burn and Reconstructive Surgery Center in Rasht, Iran.

This study was conducted based on a descriptive and cross-sectional design in Velayat Hospital in Rasht, Guilan province. The sample included all cases of self-immolation referring to Velayat Hospital from the beginning of April 2009 to the end of March 2017.The total number of self-immolated patients referred to hospital and registered was 96 individuals. Data were extracted from patients’ records using a researcher-made checklist. Descriptive statistics, such as mean, standard deviation, and analytical tests such as Poisson and multivariate logistic regression have been used for data analysis. Data were completely analyzed using STATA-SE software (version 13.1).

According to the results, 51% of the patients were female, and 67% of the cases were married; moreover, 43% of the females were housewives, and 42 % of the patients had a history of mental illness. It is worth mentioning that91% of the cases had no history of self-immolation. The most common reasons for self-immolation has been mental disorders (38.5%) and family problems (37.5%). The frequency of the rate of self-immolation has been almost equal in urban and rural areas, whereas the majority of the cases were observed in Rasht, Talesh, and Lahijan. In total, 60% of the patients died. The mean±SD age, total body surface area (TBSA), and hospitalization period were 37.5±1.5 years, 61.3±2.8, and 9.3±8 days, respectively. Analysis of regressions shows that the mortality rate has a direct and significant relationship with age and TBSA. Moreover, hospitalization time has a direct relationship with gender (i.e., male), TBSA, history of mental disease, previous records of suicide, and marital status (i.e., being married). However, it has a negative relationship with age and education.

The level of burns is high in patients who are self-immolating, and mental disorders and familial problems have been the main reason for it. Therefore, although the frequency of self-immolation rate is lower, compared to other suicide methods, thesesmall groups of patients need special care due to the high rate of mortality.

Cartilage regenerative medicine has been met with much interest due to their ability to inhibit disease progression of osteoarthritis (OA). The use of adipose-derived stem cells has been suggested as a reliable method for OA treatment because of their potential to differentiate into a variety of cell lines and their potent capability to self-renewal and repair. The aim of this study is to assess adipose-derived stem cells in combination with PRP ability in treating a patient with knee OA. A 53-year- old man with osteoarthritis was selected for this treatment. Human abdominal subcutaneous adipose sample was obtained from a patient with knee OA. Stem cells were obtained from adipose tissue of abdominal origin by digesting lipoaspirate tissue with collagenase. ADSCs cultured in DMEM medium supplemented with 10% FBS. Also, ADSCs expanded and characterized by flow cytometry. These stem cells, along with platelet-rich plasma and calcium chloride, were injected into the right knee. Pre-treatment and post-treatment MRI scans, physical therapy, and pain score data were then analyzed. The MRI data for the patient demonstrated significant positive changes. Probable cartilage regeneration was sensible in the patient. Along with MRI evidence, the measured physical therapy outcomes, subjective pain, and functional status all improved. Autologous adipose-derived stem cell injection, in conjunction with platelet-rich plasma is a promising minimally invasive therapy for osteoarthritis of human knees. The present clinical case report demonstrated that a combination of percutaneous injection of autologous ADSCs and PRPmay be able to regenerate cartilage in human knee OA.

Aplasia cutis congenita (ACC) is a rare congenital disorder that commonly affects the scalp. In this disease, some parts of the skin with or without underlying structures were not formed at birth. The aplastic lesion always presents as a solitary lesion; however, multiple lesions also were reported. In more severe cases, deeper structures, such as the subcutaneous tissue, bone, and dura, can be affected. In this study, we report a case of ACC and its management.