مجله دانشکده پزشکی اصفهان
پیاپی 621 (هفته اول تیر 1400)

Post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP) is one of the life-threatening complications of ERCP. Numerous efforts have been made to decrease the risk of PEP; however, the results were controversial. The current study aimed to assess the efficacy of local epinephrine spray on PEP reduction.

124 patients undergone ERCP were randomly divided into two groups of intervention (n = 67) and control (n = 57). The intervention group was treated with 20 ml of local epinephrine 0.02% on papilla immediately after ERCP, and the controls with similar volume of normal saline. Demographic factors, procedure-related factors (duration of procedure, volume of contrast, times of cannulation, precut sphinctrotomy, billiary balloon dilatation, asinarization, opacification, and number of pancreatic duct cannulations), as well as amylase, lipase, and hemoglobin levels at baseline and within 24 hour after the procedure were compared between the groups. Besides, the patients were assessed in terms of pancreatitis, bleeding, and perforation incidence within 12 and 24 hours after ERCP.

The two assessed groups were similar in terms of demographic and procedural-related factors (P > 0.050). Pancreatitis occurred in 1 patient (1.5%) in intervention and 6 ones (10.5%) in control group (P = 0.036). The two groups were not statistically different in terms of amylase and lipase at baseline and after ERCP. Bleeding occurred only a case (1.75%) in the control group and no one experienced perforation.

Based on the findings of the current study, local epinephrine spray can remarkably lead to decreased pancreatitis incidence as compared to the control group; however, it cannot significantly affect the pancreatic enzymes level and pancreatitis severity.

Lung cancer is by far the leading cause of cancer-related death, and the most prevalent cancer worldwide. This study aimed to investigate the presence of micro metastasis in specimens obtained from rib resections after surgery, and its impact on the recurrence rate and prognosis of patients with early-stage lung cancer.

In this cross-sectional study, 49 patients with lung cancer underwent rib biopsy during lung resection surgery, and were referred to the pathology department for micrometastasis. In the next stage, all patients were followed up and their death or survival status was determined and the survival rate of patients according to the presence or absence of rib micrometastasis was evaluated and compared.

Of the 49 studied patients, 10 (20.4%) had lung to rib micrometastasis. The mean survival time in patients with and without rib micrometastasis was 10.80 ± 1.75 and 26.58 ± 3.58 months, respectively, and the mean survival in the group with rib micrometastasis was significantly lower (P = 0.011).

It seems that the presence of rib micrometastasis in patients with lung cancer is associated with a reduced survival time. Therefore, bone biopsy of patients with lung cancer in the time of thoracotomy to determine rib micrometastasis, may be helpful in timely treatment and increase patient survival.

Fear and stress caused by COVID-19 increases the feeling of insecurity in children and adolescents, and if not taken timely action, will cause serious mental health problems in them. The aim of this study was to determine the mental health status of girls aged 12-17 years in Aran-Bidgol City, Iran, during the COVID-19 pandemic.

Methods: 

This descriptive cross-sectional study was performed on 390 girl students of Aran-Bidgol in 2020-21. Data collection tools were demographic/family information checklist and of child health questionnaire (CHQ), spiritual health, social support, and measuring the long-term effects of the accident on children's mental health, which were completed electronically. Data were analyzed using SPSS software with independent t, ANOVA, Pearson correlation, and multiple linear regression tests with a significance level of 0.05.

65.10% of girls received a score of 25-50 from the Mental Health Questionnaire, which indicated a mild mental health problem. 34.40% got a score of 50-75 and none of them got a score above 75. The regression model showed that two patterns of family communication (dialogue and compliance) and girls' existential health predicted the girls' mental health score (P < 0.05).

The results showed that the patterns of family communication and existential health in adolescents had effect on adolescents' mental health; so it is suggested to identify the best regulatory model and family function with an emphasis on existential health, to improve their mental health by gaining the ability to positive valuation.