Journal of Surgery and Trauma
Volume:10 Issue: 1, Spring 2022

Autogenous arteriovenous fistulas (AVFs) are the recommended type of vascular access for hemodialysis (HD). Nonetheless, the precise outcome of Proximal Radial Artery Arteriovenous (PRAAVF), as well as its risk of failure and complication, has yet to be determined.

In the current single-center, by retrospective analysis of prospectively collected data, we compared the outcome of Brachial Artery AVF (BAAVF) and Proximal Radial Artery Arteriovenous (PRAAVF) in end-stage renal disease (ESRD) patients who were referred to our center between 2010 to 2018. The outcome of the fistula was routinely assessed for all patients at least two years after the surgery. All data were analyzed in SPSS software (version 16). The success rate for each procedure was reported as a percentage. The Chi-square test was used to compare the success rate between the groups.

A total of 146 patients (86 males, and 60 females) with a mean age of 55.79±17.03 years were included in the study. The results demonstrated that men and women did not significantly differ in the success rate of PRAAVF (P=0.076). The PRAAVF showed a significantly higher success rate in the 30-39 age range (P=0.03). The success rate of BCAVF did not display a significant difference between different age and gender groups (P> 0.05 for both). The success rate of PRAAVF was lower in both diabetic patients and smokers, as compared to that in healthy individuals (P=0.032 and P=0.001, respectively). None of the patients who underwent PRAAVF implementation had steal syndrome (as compared to the 2.8% rate of steal syndrome following BAAVF implementation)

As evidenced by the obtained results, PRAAVFs, which are associated with a very low risk of ischemic steal syndrome, can be regarded as safe and suitable vascular access. Accordingly, when it is anatomically feasible, PRAAVFs should be preferred over BAAVFs due to their superior clinical outcomes.

Measurement of background gamma radiation in the human living environment, including hospitals, can provide useful information for epidemiological studies and authority bodies to consider appropriate strategies to reduce the exposure of these resources. Therefore, this study aimed to evaluate the background gamma radiation in surgical and other hospital wards, as well as indoors and outdoors of Valiasr, Razi, and Imam Reza hospitals in Birjand, Iran.

Measurement of background gamma was performed according to the protocols of the International Commission on Radiation Protection by X5CPLUS survey meter. This study was conducted in Valiasr, Razi, and Imam Reza hospitals, South Khorasan province, Birjand, Iran, using a Geiger- Müller dosimeter in nano Sieverts per hour (nSv/h). Measurements were taken in the general sections and five stations outside the buildings (18 stations in total), and at each station, for half an hour and every minute, the readings were recorded at a distance of one meter from the ground. The average readings as dose background gamma were reported at the measured stations.

In the present study, among three evaluated hospitals, the maximum values in Razi, Imam Reza, and Valiasr hospitals were related to the urology department (62.04±13), orthopedic unit (94.66±20), and ENT department (60.7±19), respectively. On the other hand, the maximum outdoor dose values in Razi, Valiasr, and Imam Reza hospitals were in the southwest (62.5±12), southeast (57.9±13), and northwest (57±14), respectively. Furthermore, the minimum observed background radiation values in Valiasr, Razi, and Imam Reza hospitals were related to the emergency department (47.3±17), neurology department (51.86±17), and southwest point (53.9±19), respectively.

The results of this study show that none of the hospital units nor outdoors in these hospitals can be introduced as a point where the amount of background radiation has an important concern.

One of the complications of surgery operation is deep vein thrombosis. Because of its dangerous side effects, it is important to prevent it. The purpose of this study was to determine the incidence of deep venous thrombosis in patients with DVT-associated risk factors

This cross-sectionalstudy was performed on 100 patients at high risk for probability of DVT incidence in accordance with the known risk factors of the attached checklist over one-year interval in the General Surgery Department of Imam Reza hospital. All patients underwent lower extremity bandages during operation and prophylaxis with 5,000 units of subcutaneous heparin every 8 hours after surgery. At day-3 after the operation, the Color Doppler Ultrasound of the lower extremity and the evaluation of Iliac and Femoral and Popliteal venous system in two sides (bilateral) were performed.Descriptive statistics were reported in this study.

Incidence of DVT after surgery was evaluated in one hundred high-risk patients underwent heparin prophylaxis for one year. Both sides of lower extremity venous Duplex Scan was performed on the third day after surgery operation. Only one case with partial subclinical thrombosis of the right femoral vein was found. Meanwhile, heparin did not have any complications.

Although the study seems to require a larger sample size for more accurate evaluations, given the fact that all patients were considered to be at high risk for DVT, the final result for one-percent of DVT incidence in this statistic community can be extended to larger communities with further studies.

The conventional open repairof incisional hernia requires extensive dissection. The applicability and superiority of the laparoscopy have been evolving overthe last few years.The aim of our study was to compare the surgical outcomes of laparoscopic versus open mesh repair in the management of incisional hernia.

This prospective comparative study was carried out in the SKIMS Medical College, Hospital, over a period of 5 years. The total of 62 subjects with non-complicated primary incisional hernias between 15-65 years of age were included. Polypropylene mesh in open surgery and Proceed prosthesis(ePTFE Mesh) in laparoscopy was used for repair. After hospital discharge, the patients were attached to the Out-Patient Department for follow-up. The data was collected and analyzed.

The maximum numbers of patients (41.9%) were in the age group of 36-45 years with amale to female ratio of 0.55.32 patients were operated by convention open mesh repair and 30 patients underwentintra-abdominal preperitoneal on-lay mesh repair.30.6% of female patients had history of a lower abdominal caesarean section followed by hysterectomy (17.7%). The majority of males had history of exploratory laparotomy secondary to trauma (17.7%) or peptic ulcer perforation (12.9%). The difference in mean operative time of laparoscopic technique (87±8.62 minutes)and open repair (96.56±9.31minutes) was statistically significant (p-value of 0.05).The difference between the mean duration of hospitalstay in the open repair (5.58±1.69 days) and thelaparoscopy (3.36±1.17 days) was statistically significant. None of our patients expired during the study period.

Laparoscopic management of incisional hernia is a promising alternative to conventional repair with encouraging results.In our study, it was found that laparoscopic repair is safe and resulted in lesser operative time, fewer complications, shorter hospital stay and early return to activity.

Electrical burns are a special type of burn in which a certain amount of current passes through the human body and causes different degrees of tissue injury, organ dysfunction, or sudden death. Compared with other burn patients, the amputation rate of electric burns is higher and often leads to various complications. In this study, a case of severe electric burn complicated with unilateral electric cataract was reported, which recovered well after 173 days of operation and symptomatic support.

The treatment of necrotic permanent teeth with immature apices is a daunting challenge. Apexification has been traditionally used to treat immature permanent teeth with lost pulp vitality. This technique promotes the formation of an apical barrier to close the open apex so that filling materials can be confined to the root canal. The authors present a case report of the successful treatment of a traumatized tooth with an open apex that was weakened due to a long-standing infection and thin dentin walls. In this case, we first used a triple antibiotic to disinfect the canal and then placed a calcium-enriched mixture (CEM) cement plug. Follow-up evaluations were performed 15 months after treatment. The CEM-cement appears to be a valid material to obtain periradicular healing in teeth with open apices and necrotic pulps.