نشریه جراحی ایران
سال سی‌ام شماره 2 (تابستان 1401)

The physiology of aging affects nearly every organ system including cardiovascular, pulmonary, renal and gastrointestinal. Altered physiology may also be associated with comorbid conditions including hypertension, cardiac, COPD, chronic renal disease and altered drug metabolism. American Geriatric Association has published a Criteria for potentially inappropriate medication in older adults that should be used in management of elderly trauma patients. Falls are the most common mechanism in elderly trauma patients. An Underreported injury in geriatric group is elderly abuse, which could be in a wide range of verbal insults, cuts and bruise and scratches to sexual abuse. Severely injured older patients may not display standard signs of hemodynamic instability, especially traumatic brain injury so imaging with head CT in elderly trauma patients should be used liberally.

Degenerative hip joint of diseases can cause physical inability and pain in patients. Hip arthroplasty is a standard and successful method for improving quality of life and reducing the cost of treatment for these patients. A number of surgical approaches to the hip joint exist, include direct anterior, lateral and posterior. Considering to efforts for evaluating the functional problems of these patients, the aim of this study is to comparison the functional results of the lateral and posterior procedure in hip arthroplasty, in order to determine the preferred method with the best functional results.

A total of 50 patients then randomly are divided into two groups: first lateral classical method and second Classic posterior. Patient demographic information, history of preoperative disease and postoperative complications were collected. The patients were assessed with the Harris Hip Score (HHS) at 6 month follow-up visit to evaluate functional outcome. The results of treatment patients were evaluated in 1 and 6 months after the surgery.

HHS index in the lateral and posterior groups 99.2 and 99.2 was reported respectively at 6 months after the intervention there was no statistically significant difference between the two groups. Also, the mean range of motation score in the lateral and posterior groups 298 And 299 Was reported respectively at 6 months after the intervention that there was no statistically significant difference between the two groups.

The findings of this study showed that there is no significant difference between the results of two methods of lateral and posterior surgery.

Despite the change in the pattern of diseases, in December 2019, a communicable disease has spread throughout the world. The nature of the disease necessitated hospitalization and the use of hospital services. In this study, the length of stay of patients in the hospital and its affecting factors were investigated.

In this retrospective cohort study, data of all admitted patients (8936 people) in 21 hospitals from March to June 2020 were collected from MCMC system. Considering the inclusion criteria, the data of 4890 patients after entering SPSS 16 were analyzed with descriptive and analytical statistics.

About 4890 confirmed COVID-19 cases were hospitalized. 52.3% were male and 28.4% were over 60 years old. The mean LOS of living patients was 2.6 vs. 4.1 for deceased patients(P-value &lt; 0.001). The most common clinical symptoms were cough (51.1%), fever (44.2%) and respiratory distress (40.6%). The mean stay of patients without cough and fever (3 and 2.9 days) was significantly higher than patients with these symptoms (2.4 and 2.5 days) (P-value &lt; 0.001). Unconsciousness, non-intubation, smoking, drug abuse and underlying diseases of cancer, diabetes and heart and kidney diseases with a significant relationship were among the effective factors in long LOS (P-value < 0.05).

Identifying the factors affecting the length of stay can provide useful information for the management system of COVID-19 in relation to the role of each factor and provide a basis for providing appropriate solutions to adapt the length of stay to these factors.

Recently, cesarean section (CS) has gone beyond the reasons for maintaining the health and safety of mother and baby, and the personal desires of individuals have been very influential in it. Studies have shown that the number of CS in Iran is high. The aim of this study was to determine the efficiency of the health care reform plan on cesarean delivery and its associated factors in Alzahra Hospital in Rasht during 2019.

The present study was conducted in Alzahra Educational and Medical Center as a cross-sectional study. Files of all women who had CS and vaginal deliveries in 2019 in this center were examined. The total amount of CS was calculated through the statistics of the vaginal deliveries and CS registered in this center and then the cause of CS was extracted from patients&#039; files and recorded in the checklist. To describe quantitative variables with normal distribution, mean and standard deviation, for quantitative variables with non-normal distribution, median (first quartile - third quartile) and for qualitative variables, number and percentage were used. The normal distribution of quantitative variables was measured using kurtosis and skewness values, Q-Q Plot and Shapiro-Wilk tests. Chi-square and Fisher tests were used for comparisons. The statistical significance level of the tests (P &gt; 0.05) was considered.

2460 vaginal births and 1268 Cs were performed in Alzahra hospital during 2019, and in this study, the files of 416 women with Cs were examined. The percentage of Cs in this center was 34.01% in this year. The mean age of women referring to Alzahra Hospital in Rasht for CS was 30.87±6.05 years. 0.1% of them were under 18 years old and 24.5% were over 35 years old. The mean gestational week was 37 weeks with a minimum-maximum of 28-41 weeks. The causes of CS in 211 (50.7%) patients were related to uterus, 49.3% (49.3%) were related to placenta and fetus and 27.5 (6.5%) were related to maternal underlying diseases. Among them, the history of previous CS, fetal distress and preeclampsia were more frequent in each section, respectively. In total, history of previous CS (45.9%), fetal distress (19.0%), meconium excretion (13.9%), multiple births (7.2%) and breach view (0.6%), respectively were most causes of CS in this center. Based on the results, a significant relationship was observed between maternal age and number of pregnancies with causes related to uterus, placenta and fetus.

The frequency of CS in Alzahra Hospital in 2019 has decreased significantly compared to the time before the Health Reforming Plan. Although this percentage has decreased compared to the previous study, it is still higher than the statistics defined by the World Health Organization and it is still necessary to try to reduce this frequency by considering the safety of mother and baby.

Fracture fixation components and implants are widely used in orthopedic surgery as well as dentistry. The use of metal stabilizers is very common, which imposes the need for a second surgery to remove the implant from the body. One of the most common implants is the interference screw, which is used in many bone injuries. Therefore, the purpose of this research is to obtain an optimal sample for use as an interference screw, and for this purpose, nanocomposites with different percentages of nanomaterials were made.

This study was conducted as a research study and 9 samples were made and examined. For this purpose, hand injection molding, was designed to prepare screws in laboratory scale, first. For making samples, poly (L) lactic acid, nano hydroxyapatite as reinforce and polyethylene glycol as plasticizer were used. These samples were made by combination of solvent casting and melt processing methods. Adding nano hydroxyapatite and polyethylene glycol together lead to improve tensile and percent elongation of samples. After doing different tests like tensile, rheology, biodegradability and biocompatibility, the optimized sample was chosen. Data were obtained as mean ± standard deviation (MEAN ± SD) and for statistical analysis SPSS software (version 16) was used and one-way analysis of variance (ANOVA) was used, the level of significant differences with P&lt; 0 / 005 was calculated.

It was found that the simultaneous addition of nanohydroxyapatite and polyethylene glycol increased the strength and elongation at break of the samples. The optimal Young&#039;s modulus was 589/93 ± 43/912 MPa and the Young&#039;s modulus of the polymeric matrix was 615/4± 48/421. Although the polymer matrix has a higher Young&#039;s modulus, it is not suitable for use in areas under load due to its inherent fragility and also has low bioactivity. The rate of increase in elongation at break of the optimal sample was 13/39 ± 2/731 and for the polymeric matrix was 11/01± 1/348.

Findings obtained from this study showed that the optimal sample of this study (1051) with 1% hydroxyapatite and 5% polyethylene glycol. Because it has the highest percentage of elongation and the lowest degree of fragility and can be an optimal formula for biodegradable interference screws.

Social networks in general and scientific social networks in particular have always attracted the attention of human groups and communities. The purpose of this article is to investigate the willingness to attend and use these communication tools from various aspects.

The present study is a fundamental study that examines the requirements for the use of scientific social networks in universities and research environments with a library approach. The views and opinions of different people have been studied and the effects of using social networks on the scientometric indicators of databases have been introduced.

The results of Altmetrics studies in the field of medical sciences show that the activities of researchers in social networks have a positive and significant effect on scientific metrics. In the studied researches, Altmetrics indices have been introduced as alternative measures of traditional methods for measuring and evaluating researches and calculating the amount of scientific effects used. The results of the conducted research show that the activity in scientific social networks has led to the favor and attention of other peers and has a positive effect on the recognition of people in scientific societies and, as a result, the increase of scientometric indicators such as the H-index score and it has the number of citations received.

Given the positive role of scientific social networks in increasing scientific indicators, officials of universities and research institutes should encourage researchers to use scientific social networks and teach them how to do it. Not only enhance their achievements, but also increase the impact and knowledge of their respective research units.

In our country, despite the fact that the "principle" is to prohibit abortion, but in limited and specific cases of this principle, an "exception" has been made and its license has been issued. Of course, none of these permits covers the issue of abortion from an illegitimate relationship, and the legislature has not permitted abortion based on an unmarried relationship. Due to the prohibition of abortion, even in cases where the fetus is the result of an extramarital affair, if the doctor intervenes in the abortion, he will be criminally liable and will face legal punishment. The physician will be released from liability if he or she proves one of the obstacles to criminal liability, such as the need to intervene (save the mother&#039;s life) or illegitimate fetal malformations (medical abortion) in specific legal cases (Family Protection and Youth Law of 1400); In other words, the protections that apply to embryos resulting from legal marriage also apply to embryos resulting from illicit intercourse, and the same exceptions apply to them; But this legal application is not compatible with social conditions and developments and creates many problems for the mother, society and especially the born child.