Academic Journal of Surgery (AJS - Tehran University of Medical Sciences)
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Investigating the relationship between the increase in color doppler ultrasound indices of the ophthalmic artery and the serum lactate level and the severity of the disease in patients with sepsis.
Get PDFBackground: The objective of this study was to investigate the relationship between the increase in colorDoppler ultrasound indices of the ophthalmic artery and the serum lactate level and the severity of the disease in patients with sepsis.Methods: This was a cross-sectional study conducted on 24 patients diagnosed with sepsis, who were admittedto the intensive care unit of Shariati Hospital. The patients were more than 18 years old, hospitalized in thefirst 42 hours, and selected by the portable color Doppler ultrasound available in the ICU department. The ESIprobe was placed on the patient’s eye with the eyelid closed, and the ophthalmic artery was located. The indices including RI, PSV, PI were measured along with their serum lactate levels. The correlation of these indices with the severity of sepsis was checked.Results: In this study, 24 patients who were less than 81 years old were diagnosed with sepsis and had a sofascore above 3. It was observed that there is a significant relationship between the dose of increased lactate levelsand PSV1, and this parameter can be considered a predictive factor. It was also observed that there is a significantrelationship between the dose of increased lactate levels and PSV2, and this parameter can be considered as am predictive factor. Additionally, there is a significant relationship between the dose of increased levels of lactateand PI, and this parameter can be considered as a predictive factor.Conclusions: The study found a significant relationship between increased levels of lactate and decreased bloodsupply in the optic artery. It is suggested that due to the lack of numbers in this study, more samples should be investigated in future studies. In a scientific article, the use of “we” and “our” should be avoided. If necessary, the third person should be used
Comparative Study of Quality of Life After Surgery in Sigmoid and Rectal Cancers: A Single-Center Prospective Study
Get PDFBackground: Sigmoid and rectal cancers are common malignancies that necessitate surgical resection as theprimary treatment modality. However, surgery can significantly impact the quality of life (QoL) of patients,particularly in terms of bowel function, sexual function, and psychological well-being. This study aimed tocompare the QoL of patients who underwent surgery for sigmoid and rectal cancers.Methods: A prospective study was conducted on 90 patients who underwent elective surgery for sigmoid or rectalcancer between January 2019 and December 2021 at the center. The QLQ-C30 and QLQ-CR29 questionnaireswere utilized to assess the QoL of patients post-surgery. The QoL scores between the two groups were compared using t-tests and repeated measures ANOVA.Results: The average age of the patients was years, and 57.8% were females. The sigmoid group comprised44 patients (48.8%) who underwent sigmoid colectomy, and the rectal group consisted of 46 patients (51.2%)who underwent low anterior resection. There were no significant differences in the baseline characteristics andQLQ-C30 scores between the two groups and also in other categories (sex, age groups, and cancer stages) (p >0.05). However, a significant difference was observed between the QLQ-CR29 scores of the two surgical groups(p < 0.05). QLQ-CR29 was not significantly different between sex and age groups and cancer stages (p > 0.05).Conclusions: The study demonstrated that surgery for sigmoid and rectal cancers deteriorated the QoL ofpatients, irrespective of the type of surgery or the location of the tumor. There was no significant difference in the QoL between the sigmoid and rectal groups measured by QLQ-C30. However, QLQ-CR29 showed significantlybetter QoL for the rectal group.
 
Bacteriology of Surgical Site Infections and Antibiotic Susceptibility Pattern in Isolates of Postoperative Wound Infections
Get PDFBackground: We aimed to evaluate the isolates of postsurgical infections, and study their sensitivity; so that strategies could be made by using proper antibiotic treatments.Methods: Study isolates were obtained by swabs/pus from the subjects reported for surgical site infections (SSIs) at surgery department of a governmental tertiary care hospital, Nagpur, India, and were further transferred to the pathology department during the period from June 2009 to November 2011. About 250 cases of surgical site infection were evaluated with isolates form different surgical sites which were surmised to be infected based on clinical evaluation. The isolates were subjected to standard procedures, and antibiotic susceptibility test opting modified Kirby-Bauer disc diffusion technique.Results: Twelve types of organisms were isolated; most common was Klebsiella species (23.7%), Staphylococcus aureus (20.00%), followed by Escherichia coli (15.1%), Pseudomonas aeruginosa (13.4%), coagulase-negative staphylococci (CoNS) (11.0%), etc. Results suggested 50% of the isolates having Staphylococcus aureus were resistant to methicillin. More than 60% of isolates having Escherichia coli and Pseudomonas aeruginosa were resistant to gentamicin. The number of isolate showing resistance to 3rd generation cephalosporins and the quinolone antibiotics was high.Conclusions: Surgical site infections crowded with multi-resistant organisms, not only increase the economic burden in the form of antibiotics, but also pose a serious threat to patients undergoing surgery. To avoid such infections, there is an urgent need to follow aseptic and sterilization techniques, also rationale use of antibiotics has to be done
The Outcomes of Left Thoracotomy and Esophagogastrostomy Method in Patients with Esophageal Cancer in Babol City, Northern Iran (2004-2011)
Get PDFBackground: Since esophageal cancer is highly prevalent, and has a high cost for patients and society, this study aimed to investigate the result of surgery in esophageal cancer with esophagogastrostomy method to lower the problems of these patients.Methods: In this cross-sectional study, all patients who were diagnosed with esophageal and upper gastric cancer with surgical indications during 2004 to 2011 in Shahid Beheshti hospital, Babol City, Iran, participated. Patients then underwent esophagogastrostomy surgery. Patients’ data were gathered using a survey and analyzed using t and chi-square tests via SPSS software. A P-value of less than 0.05 was deemed statistically significant.Results: A total of 47 patients who were confirmed as having esophageal cancer by pathologic evaluation, were investigated. A significant relationship was observed between body mass index and complications after surgery (P = 0.04). 57.1% of underweight patients and 100% of obese patients experienced complications. No significant relationship was seen in other factors. The average age of patients who experienced complications was higher than those who reported no complications, and the difference was statistically significant (P = 0.03). Moreover, the duration of surgery was significantly higher in patients with complications (P = 0.01).Conclusions: It would seem that complications after surgery were higher in underweight patients and the duration of surgery was higher in these patients. No significant relationship was seen in other factors.
 
Comparison of the Efficacy of Oral Simvastatin and Topical Simvastatin Solution in Decreasing Post-Laparotomy Adhesions in Rats
Get PDFBackground: Intra-abdominal adhesions and their complications occur frequently after laparotomy. The aim of this study was to compare oral versus intraperitoneal administration of simvastatin in decreasing postlaparotomy adhesions in rat.Methods: Thirty male Wistar albino rats were divided into three groups of ten. All the rats underwent laparotomy and induction of adhesions using the method of Meso-Stitch approximation of injured cecum and abdominal wall. One group received oral simvastatin (40 mg/kg) daily during two weeks before the laparotomy. In the two other groups, 2 ml of solution of simvastatin (40 mg/kg) or distilled water (as placebo) was spilled into abdomen before closing abdominal wall, respectively. After 14 days, all the rats were put under laparotomy again to be compared. Rates and grades of adhesions were assessed using Hoffman et al. and Lauder et al. Scale and histopathological reports.Results: In placebo group, the grade II and III adhesion was seen in 2 and 8 rats, respectively. In local simvastatin group, there was no adhesion in 5 rats, and grade I and II adhesion was seen in 3 and 2 rats, respectively. In oral simvastatin group, 6 rats were without adhesion, and 3 cases with grade I and 1 case with grade II adhesion. The frequency and grade of adhesion were statistically different in simvastatin groups compared to the placebo group (P < 0.001), but not with each other.Conclusions: Oral simvastatin for two weeks before the laparotomy can reduce post-laparotomy adhesion bands as well as local administration of simvastatin solution
The Reliability and Effectiveness of European Organization for Research and Treatment of Cancer Quality of Life Questionnaire, Core Head and Neck Module (EORTC QLQ-H&N35) in Head and Neck Cancer
Get PDFBackground: We aimed to test the validation of the European organization for research and treatment of cancer (EORTC) quality of life questionnaires for head and neck module (QLQ-H&N35) in a tertiary care center.Methods: Forty patients with head and neck malignancy completed the QLQ-H&N35 while undergoing their treatment. Questionnaires given to them were translated into their regional language Kannada. Evaluation of the responsiveness, reliability, and validity of the questionnaire was undertaken.Results: The data assessed the reliability of the scales and not validity. The questionnaire was receptive to changes over time; however, the applicability of the European questionnaire in Indian clinical set up was debatable.Conclusions: Our data suggests that the EORTC QLO-H&N35 is reliable and responsive when applied to patients with head and neck cancer in India. Hence, it may be used as a platform to test validity at a multicentric level.
 
Recurrence of Abdominal Aortic Aneurysm, Rare Complication of Disease
Get PDFBackground: Abdominal aortic aneurysm (AAA) is one of vascular surgery challenges, because of its differences in decision making about time and type of surgery (open vs. endovascular).Case Report: We have case of patient with old pulmonary tuberculosis came with recurrence of AAA after open surgery. We decided to perform endovascular treatment, but there was an anatomical difficulty for device selection.Conclusions: Although recurrence of AAA is rare, it has more diagnostic and therapeutic challenge. Recurrence after open surgery occurs less than endovascular surgery. Treatment after open surgery is better to conducted with endovascular manner, because of general condition of patient and probable difficult abdomen due to adhesion of previous laparotomy
Gastrointestinal Basidiomycosis: An Unusual Fungal Disease?
Get PDFBackground: Basidiobolus ranarum is a fungus that usually causes subcutaneous infection. Medical literature rarely report gastrointestinal involvement, especially in tropical climate areas.Case Report: Here we report a case of gastrointestinal basidiomycosis in an immunocompetent 43-year-old man from south of Iran who presented with abdominal pain, loss of appetite, and nausea. He had history of previous laparotomy 10 years ago, because of perforated peptic ulcer. He underwent an exploratory laparotomy. We found a mass in ascending colon; so, right hemicolectomy were done. Histologic founding were amazing. Eosinophilic sheath surrounding hyphae-like structures was seen. The diagnosis of basidiomycosis was established, so we prescribed antifungal agents for the patient. He expired 6 months later according to disseminated disease.Conclusions: Gastrointestinal basidiomycosis is a rare and invasive fungal infection that imitates malignant tumors, inflammatory bowel disease, or even phlegmon of appendicitis. Diagnosis of gastrointestinal basidiomycosis needs a high index of suspicion. The physicians should be aware of this disease as differential diagnosis in tropical areas. Surgical resection and prolonged antifungal therapy is recommended, but in some cases, the disease may spread and cause death