Academic Journal of Surgery (AJS - Tehran University of Medical Sciences)
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Complications, Indications and Results of Two Screening Methods: Amniocentesis and Chorionic Villus Sampling
Get PDFBackground: Chorionic villus sampling (CVS) and amniocentesis are two invasive methods of diagnostic approaches for prenatal diagnosis. The indication, adverse effects and final outcome of these two methods are different. The goal of this study was to compare indication, complications and outcomes of CVS and amniocentesis in pregnant women underwent prenatal screening program.Methods: Medical records of 1464 women who underwent CVS, or amniocentesis were reviewed in two tertiary hospitals (imam and women hospitals, affiliated hospitals of Tehran University of Medical Sciences).Results: For 1073 patients amniocentesis was performed while for 391 cases CVS was one. Mean maternal age, gestational age, and age at birth of the neonates were significantly lower in CVS group than the other group. Mean needle time was significantly higher in CVS group. Mean needle time was significantly higher in CVS Group (1.3 vs. 1.5, P < 0.001). The most finding of CVS result was minor Thalassemia while trisomy 21 was the most finding in amniocentesis group. Rupture of membranes was the most side effects in amniocentesis group and intrauterine fetal death was the most complication in CVS group.Conclusions: Indication, results and complications of CVS and amniocentesis are different
Posterior Surgical Approach for Cervical Fracture in a Patient with Diffuse Idiopathic Skeletal Hyperostosis: A Case Report
Get PDFBackground: To explain posterior approach for a case with vertebral fracture caused by trauma in a patient with diffuse idiopathic skeletal hyperostosis (DISH) and evaluation its outcome and effects.Case Presentation: A 57 years-old man came to emergency room due to falling and severe cervical pain. The patient was neurologically intact and radiological surveys revealed fractures in C6 cervical vertebrae in addition to hyperostosis in the lumbar and thoracic spine. We fixed fractured vertebra by lateral mass screws through a posterior approach with bony fusion (without laminectomy).Results: The patient was mobilized the day after operation and discharged from hospital 3 days later. One year follow up showed acceptable bony fusion and no complication was reported.Conclusions: Posterior approach is an effective and simple procedure in comparison to other approaches and can be used safely with minimal side effects in selected patients with DISH
Survey of Factors that Affect the Arteriovenous Fistulas Survival in Semnan and Mahdishahr, Iran
Get PDFBackground: First step in chronic dialysis is establishing a suitable dialysis access. Arteriovenous fistula (AVF) has been known as the gold standard for hemodialysis; and due to complex interaction of factors that affect thesurvival time of fistula, we decided to evaluate survival time and affective factors among the dialysis patients.Methods: In a historical cohort study, we analyzed 52 patients of the Semnan and Mahdishahr Dialysis Centers. The data recorded by history taking and physical examination.Results: The survival of fistula was 83%, 80%, 67%, and 40% after 1, 3, 5, and 10 years respectively. Our results showed that the survival time of fistula was higher among patients with left-side AVFs. Factors such asage, gender, underlying disease, dialysis session per week, the time that patients started dialysis after installing fistula and fistula infection did not statistical significant affect the survival time.Conclusions: The survival time of AVF among dialysis patients of Semnan and Mahdishahr is satisfying, and installing the fistula in left hand lead to higher survival
Effect of Systemic Granisetron in the Clinical Course of Spinal Anesthesia with Hyperbaric Bupivacaine for Outpatient Cystoscopy
Get PDFBackground: The goals of this study are evaluation the effect of intravenous (IV) granisetron on the duration of sensory and motor block produced by intrathecal hyperbaric bupivacaine and also post-operative nausea and vomiting in patients undergoing outpatient cystoscopy.Methods: 62 patients, undergoing cystoscopy received either 3 mg IV granisetron or placebo 15 minutes before the spinal block. Sensory and motor block were assessed after the intrathecal injection of bupivacaine every 2 minutes until the maximum block was achieved and thereafter every 15 minutes until recovery from the sensory and motor block.Results: Demographic data were not statistically different in the study groups. Duration of sensory and motor block were also not statistically different between the study groups (P = 0.060 and P = 0.070 respectively). No patient in either group had vomiting. Seven patients in saline and zero patient in granisetron group had nausea that was statistically significant (P = 0.040). Time to discharge after surgery was 243 ± 21 and 239 ± 24 minutes in granisetron and control group respectively (P = 0.150).Conclusions: Systemic granisetron had no effect on the duration of sensory and motor block produced by spinal anesthesia with hyperbaric bupivacaine