Journal of Surgery and Trauma
Volume:10 Issue: 3, Autumn 2022

Superficial cancers are one of the most common cancers in humans and animals. The use of maggot therapy as an alternative treatment is expanding and has achieved great success in treating superficial. Maggot extracts and secretions have been also demonstrated to have beneficial biological effects. The present study aimed to perform the first systematic review of the use of maggot, as well as its secretions and extracts, in neoplasms.

In the current review study, online databases, such as Pub Med, Web of Science, Scopus, and Embase, were searched to retrieve the published studies from 1985-2021. The used keywords were Maggot therapy, Larval therapy, Larval extract, Larval secretions, Cancer, Neoplasm, and Tumor. Only research on the larvae of the order Diptera was included in the present study.

Out of 387 screened papers, 9 articles met the proposed inclusion criteria. There were three articles on the use of maggot debridement therapy in tumor lesions and six articles on the effect of maggot secretions and extract on neoplastic cells. Maggot debridement therapy has been able to control the complications of skin tumors and breast cancer. Several studies have also reported anti-tumor effects on larval extracts and secretions.

Maggots were able to improve the appearance of lesions and prevent further tumor growth that was progressing before larval therapy. It seems that maggot therapy can be used to treat necrotic tumors; moreover, its extract and secretions can be used to treat a wider range of cancers in humans and animals. Nonetheless, more studies are needed in non-progressive cancers to determine the true effects of this method.

A consistent concern of surgeons is postoperative pain, whose control both alleviates patient suffering and reduces surgical complications, resulting in a quicker discharge and lower costs. This study aimed to compare abdominal pain (epigastric and right-upper quadrant) and pain at umbilical and subxiphoid ports after laparoscopic cholecystectomy in elective candidates at Afzalipour Medical Education Center, Kerman, Iran.

In this clinical trial, 76 candidates for elective laparoscopic cholecystectomy were assigned to one of two groups via a simple random allocation method. Gallbladders were removed from the subxiphoid port in the control group and the umbilical port in the case group. Postoperative pain was assessed using the Visual Analogue Scale (VAS), and the analgesic consumption was measured at 6 hours, 24 hours, and two weeks postoperatively. Data were analyzed by SPSS 16 software using independent t-test, chi-square, and repeated measures test.

The mean port site pain score in the control group at 6 hours after surgery was 6.6±2.2, and in the case group, 6.3±1.9, and this difference was not statistically significant (P=0.519). The mean port pain score in the control group at 24 hours after surgery was 5.5±1.6 and in the control group was 4.9±1.1, where the difference was statistically significant (P<0.01). The mean port site pain score in the control group two weeks after surgery was 0.6±4.1, while in the control group, it was 3.0±0.9, where the difference was statistically significant (P<0.01).

The results of our study demonstrated for the first time that there was no significant difference between patients whose gallbladder was removed through the umbilical port and those whose gallbladder was removed through the subxiphoid port concerning abdominal pain (epigastric and RUQ). Nevertheless, the removal of the gallbladder from the umbilical port 24 hours and two weeks after surgery reduced the patient’s port pain. This finding was evidenced descriptively by the VAS and quantitatively by the decline in analgesic prescriptions. Moreover, abdominal pain (epigastric and RUQ) was lower in patients with shorter operations.

Central vein catheterization (CVC) is a usual and accepted way for monitoring hemodynamic status or prescribing medication in seriously ill patients. internal jugular catheterization, is one of the most acceptable roots for catheterization, because of its accessibility and ability to compress the vein, but in the standard method explained in Robert and Hedges, clinical procedures textbook, there is significant instruction for needle direction and patient position but in some cases, this method is not successful, especially in beginner and trainer students. So new studies have examined new methods in previous approaches (such as the use of ultrasound guides). This paper is about a modified method of catheterization, with a simple modification in needle direction and patient position, based on emergency medicine specialists experience, without any excessive instruments, this method can be used by other physicians as will be explained subsequently.

This study reports the success rate and complications of a verified method of central vein catheterization (CVC) by emergency medicine specialists.

After preparation and cardiac monitoring, the patient is in a neutral position with the head rotate 20-30 degrees to the other side and feet are in line with the body. Then the needle was inserted from the middle of both ends of the sternocleidomastoid muscle, one centimeter above the clavicle bone while the direction of the needle was toward the foot on the same side and along the internal jugular vein, the angle between the skin and needle was 30-40 degrees. While applying negative pressure (suction), after passing the needle through the skin, it was gently inserted into the site up to the 2.5 centimeter distance of the needle tip. In case of unsuccessful venipuncture, the needle was pulled backward gently to the surface of the skin while maintaining suction. In the case of a blood jet inside a vein, the wire was first passed and then a catheter was inserted. After catheterization, chest X-ray was taken from all patients, and complications were checked.

In this trial, all CVC was successful and 9 CVC were with simple complications such as catheter location in the left ventricle (n=3), in the carotid artery (n=1), pneumothorax and hemothorax (n=1).

 Since the vein is more available in the innovative modified method than the standard method, it may be preferred to the standard conventional method.

 Evaluating self-efficacy beliefs is essential to the post-operative care program in cardiovascular bypass patients. The present study aimed to investigate the role of self-efficacy beliefs in positive and negative perceptions of stress in coronary artery bypass patients.

The research method was descriptive-analytic, and its population consisted of patients with coronary artery bypass who were referred to the education and treatment specialist center of Vali-e-Asr Hospital, Birjand, Iran, in 2016. The available sampling method was applied, and 229 patients were selected. Data were collected using questionnaires of Zand's self-efficacy beliefs and Cohen's perceived stress. The data were then analyzed by SPSS (Version-23) using the Pearson correlation test, stepwise regression, and independent-sample t-test.

The findings showed a significant correlation between the variables of research. Among the components of self-efficacy beliefs, physical activity predicted a positive perception of stress (R=0.274). Moreover, physical activity and psychosocial stresses could predict negative perceptions of stress. The negative perception of stress and self-efficacy beliefs were significantly different between male and female patients (P<0.05).

 According to the findings, physical activity, as one of the dimensions of self-efficacy beliefs, has a positive effect on the perception of stress. Therefore, self-efficacy beliefs are valuable tools for health care providers and staff. Furthermore, evaluating patients' self-efficacy beliefs and improvements can increase their motivation to take care of themselves.

Inguinal hernia repair is a very common surgical procedure. To our knowledge, there are no reports of inguinal hernias crossing the midline from left to right (or vice versa). An 82-year-old man presented in our outpatient clinic with a large inguinoscrotal hernia on the right side. Medical history showed among others an open cystectomy and urostomy because of bladder cancer. He was therefore scheduled for routine repair via Lichtenstein’s technique. A hernia sac was found, but further exploration revealed that its origin was not inguinal or femoral on the right side. The hernia sac crossed the midline and turned out to be from a medial inguinal hernia on the left side. This report describes a rare case of a left-sided inguinoscrotal hernia mimicking a right-sided hernia. Especially in patients with a laparotomy in their medical history, radiological imaging pre-operatively could be useful for diagnosing this rare phenomenon.

COVID-19 is a pandemic and general health urgency with global concern which is rapidly spreading with the new sign. A 72-years-old man with diagnosis of myocardial infarction is transferred to the operating room for the coronary artery bypass surgery. The coronavirus-2019 test and the other diagnostic methods related to it were done and the result was negative. He returned to the hospital with hypotension two months after surgery. At first, the surgeon thought that these symptoms were related to the side effects of the cardiac medicines, so stopped taking and decreased the dose of those medicines. However, the hypotension persisted while the patient complained of anorexia, dizziness, and nausea. Considering the fact that the patient’s daughter was a health care worker who suffered from COVID-19, chest High-Resolution CT (HRCT) was conducted showing multi-focal peripheral consolidations in both lungs purposing viral pneumonia. Consequently, the patient was isolated. COVID-19 Polymerase Chain Reaction (PCR) was cheeked, which turned out to be positive and confirmed the diagnosis. Patients received intensive care in the hospital for six days and were discharged in good general condition to pass the rest of the isolation period at home. It is recommended according to the common symptoms of the coronavirus-2019 disease and the side effects of the cardiac patients’ medicines, such as vertigo, nausea, and vomiting, that these symptoms, in the case of these symptoms’ occurrence for the patients of coronary artery bypass surgery, can be resulted from the coronavirus-2019 disease, not from the medicine effects.