مجله دانشکده پزشکی اصفهان
پیاپی 624 (هفته چهارم تیر 1400)

Inguinal hernia is a common and widespread disease in the world that millions of people suffer from. Inguinal hernia repair is one of the most common general surgeries. Despite the high prevalence of this disease, no type of surgery has ideal results and postoperative complications still remain. The aim of the current study was to evaluate therapeutic consequences of laparoscopic hernia surgery with totally extraperitoneal (TEP) with and/or without Takers.

Out of 54 patients studied in this clinical trial study, 27 patients underwent TEP using Takers and 27 patients without Taker. The findings were recorded during the operation and compared in 6-month follow-up using a questionnaire.

The duration of operation, the duration of hospitalization, the duration of postoperative pain, and the duration of return to work and normal daily activities were the same in both groups. In terms of hernia recurrence rate, one recurrence was observed in each group. Other complications including infection, neuralgia, and postoperative hematoma were not observed in any of the groups.

The present study showed that in patients with inguinal hernia after repair by TEP method, it may not be necessary to use Takers for mesh fixation.

Cardiopulmonary bypass (CPB) has many benefits in improving heart surgery; but this method may cause kidney damage and kidney failure in some patients. N-acetylcysteine (NAC) is an anti-inflammatory agent that has protective effects on kidney function. The aim of the present study was to evaluate the effects of NAC on prevention of renal failure following CPB.

In this double-blind clinical trial study, 100 patients who were candidates for coronary artery bypass grafting (CABG) at Shahid Chamran hospital in Isfahan, Iran, aged 40-65 years with glomerular filtration rate (GFR) of greater than 60 and creatinine level of less than 1.5 mg/dl were selected. The intervention group received 1200 mg of NAC in Prime solution. NAC was not used in the control group. The two groups were compared in terms of GFR and mortality. Data on blood levels of urea, creatinine, urine output, and intensive care unit (ICU) stay were collected.

Patients in the two groups had relatively similar conditions in terms of mean age, height, weight, aortic clamp time, and pump. No mortality was reported in any of the groups. There was no significant difference between the ICU stay and the amount of urea in the two groups of intervention and control (P > 0.050). There was a significant difference in the urine output of patients in both groups in the first 24 hours after CPB (P < 0.050); but in the second 24 hours, the difference was not significant. There was significant differences in creatinine and GFR levels of patients with diabetes mellitus in the intervention group with other patients (P < 0.050). No patient death was reported in any of the statistical population groups.

The results show that the use of NAC reduces creatinine and increases GFR in patients with diabetes mellitus, which indicates that the use of NAC may prevent renal failure in these patients.

COVID-19 is an infection caused by the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-COV-2) virus. Today, the goal of health providers and policymakers around the world is to prevent and control the severity of disease outcomes by making and using vaccines. The present study is a letter to the editor based on the authors' experiences and other studies around the world. It is possible to increase the acceptance of the COVID-19 vaccine in the community with solutions such as sensitization through education and information about vaccines, encouraging the production of COVID-19 vaccines for factories producing, creating exponential demand for vaccines, secure access to vaccines, approving preconditions for receiving vaccines to register and enter Government centers and the employment of manpower, and the provision of educational and health facilities. Vaccine acceptance strategies can increase the acceptance of COVID-19 vaccine in the community, and take useful and effective steps to prevent or reduce the consequences of the disease.