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Showing 14 results for Surgery
Rahim Masoomi,
Volume 4, Issue 2 (6-2004)
Abstract
Background & Objectives: Senile cataract is one of the most common diseases in the world and a common cause for reduced visual acuteness and blindness. It is due to many factors the most important of which is aging. Other risk factors include gender, smoking, sunlight, living environment, high risk professions, family history, systemic diseases, etc. The present study was an attempt to investigate this disease epidemiologically and draw a general profile for it in order to pave the way for further research. Methods: This was a cross-sectional descriptive and retrospective study. The files of the patients who had received senile cataract surgical operation in Alavi hospital from March 1999 to February 2000 were investigated to collect the required data. The data were analyzed using appropriate statistical methods. Results: 218 patients were studied. The prevalence of this disease was found to be 83.9% which was observed among males more than females and was more common in the 6th decade of life. The disease was mostly seen in the left eye and reduced visual activity to the light perception was the most common clinical complaint among the patients. 29% of the patients were diabetic and 22.1% of them had hypertension. Conclusion: Because of high prevalance of cataract, it is necessary to have good medical care and management. Moreover, some training and guidelines seem necesarry.
Rahim Masoumi,
Volume 4, Issue 4 (12-2004)
Abstract
Background & Objectives: Congenital cataract surgery is one of the complicated and difficult surgeries in ophthalmology. Its prevalance is one per 2000 live birth but it is one the main causes of blindness in children. This prevalence is even higher in underdeveloped countries (30 in 100000 cases). Lensectomy & vitrectomy by vitrectome device are the latest methods in this regard. The objective of this study was to evaluate the post-operative results of this method of surgery in patients operated because of congenital cataract. Methods: After the diagnosis of the congenital cataract and primary examinations, the patients, in necessary cases, were examined under anesthesia and if possible, in all patients retinoscopy was conducted and intraocular presure was measured. If the examination of the retin was possible, the red reflex was determined. Then the patients were garded to D( absence of cloudy lens), 1( the presence of opacity up to 1 mm), 2A (the area of apaque part less than nonopaque area), 2B (the area of opaque part more than nonopaque area) and 3 ( complete opaqcity of lens). All of the patients were evaluated in two groups: first, only congenital cataract second cataract due to trauma. Results: In the first group (with 24 patients and 33 eyes). 26 eyes (79%) had very good postoperative condition, 4 eyes (12%) had good condition and 3 eyes (9%) were nearly good. In the second group including 17 patients, 9 eyes (56%) were very good and 4 eyes (26%) good and 4 eyes (26%) moderate in terms of postoperative results, and none of them had poor results. Conclusion: Because of the good surgical results of lensectomy and vitrectomy in congenital cataract and rapid visual acuity they are still methods of choice in congenital cataract surgery.
Hormoz Ayromlou, Naser Safaii, Nasrolah Maghamipour ,
Volume 5, Issue 1 (4-2005)
Abstract
Ulnar nerve involvement is the second most common local mononeuropathy. The ulnar nerve consists of motor and sensory fibers that arise in C8-T1 roots and extends to the lower trunk and medial cord of brachial plexus. Manifestations of this nerve involvement range from elbow pain and intermittent hand paresthesia to marked sensory loss, wasting and weakness of hand muscles and a claw hand. Ulnar nerve lesion in the elbow region commonly follows surgery in which general anesthesia is used (particularly in patients with coronary artery bypass graft surgery). The patient presented in this article was a 56-year-old male who was involved in left ulnar nerve lesion after undergoing coronary artery bypass graft. In electrodiagnostic study we noticed diffused demyelination lesion of the ulnar nerve with dominancy in elbow region along with secondary axonal degeneration. Therefore, suitable positioning of elbow is recommended to avoid the nervous complications of these operations.
Masuood Naderpour , Yalda Jabbary Moghaddam ,
Volume 5, Issue 4 (12-2005)
Abstract
Background & Objectives: Acute otitis media is the second most common disease of childhood. With inappropriate treatment, it can progress to chronic otitis media which requires surgical intervention. Surgical treatment of chronic otitis media is based on the following two principles: complete removal of pathologic tissues and improvement of hearing level. Trauma to the inner ear cochlea (caused by suctioning, surgical drill and ossicular manipulation at the time of surgery) may cause sensorineural hearing loss. Even slight additional hearing loss can profoundly affect these patients. The objective of this study is to assess sensorineural hearing loss following surgery for chronic otitis media. Method s : This is a comparative, analytic and cross-sectional study performed on 100 patients admitted to ENT ward of Imam Khomeini Hospital in Tabriz between 2000 and 2002. The data were analyzed after being collected using pre and postoperative audiograms. Results: By comparing pre and postoperative audiograms, postoperative sensorineural hearing loss was found in 6 patients (6%) 5 of whom were female. The highest complication rate was seen following tympanoplasty with ossicular reconstruction. No cases of sensorineural hearing loss was found following radical and modified mastoidectomy. Conclusion: Any type of surgical procedures in the middle ear has the potential risk for acoustic trauma and consequent hearing loss. Because middle ear surgery is performed to improve the ear function, more attention should be paid to this risk. In our study ossicular manipulation played a major role in causing sensorineural hearing loss as a postoperative complication.
Masoud Entezariasl, Khatereh Isazadefar , Ghodrat Akhavanakbari,
Volume 7, Issue 3 (9-2007)
Abstract
Background & Objectives: Postoperative nausea and vomiting are among the main complication after anesthesia and various methods are used for the prevention of this complication. In this study, the effect of the pre induction use of 10mg Metoclopramide’ 8 mg Dexamethasone and the combination of the both, on decreasing in the rate of nausea and vomiting after cataract surgery in intravenous anesthesia is compared with placebo. Methods: In this double blind clinical trial, one hundred patients of cataract surgery who are appropriate for this study were, randomly divided in to four groups. In the group of placebo (P), 2cc normal saline, in group (M), 10mg metoclopramide, in group (D), 8mg Dexamethasone, and in group (M+D), 10mg metoclopramide and 8 mg Dexamethasone, one minute before the induction of anesthesia was injected. Patients were received the anesthetic drugs in the sameway and after the tracheal intubation infusion of propofol was started. After the end of surgical operation, the appearance of nausea and vomiting in the recovery room and also 6 and 24 hours after the surgery are recorded in the patients' information forms. Finally the data were analysed by statistical software of SPSS and the statistical tests. Results: After the use of these drugs, the rate of nausea in the recovery room decreased from 44% in placebo to 20% in metoclopromide group, 16% in Dexamethasone group, and 8% in combination of metoclopromide and Dexamethasone and the rate of vomiting decreased from 20% in placebo group to 4% in metoclopromide group, 4% in Dexamethasone group, and 0% in combination of these two drugs, both the nausea and vomiting the effect of combination of metoclopromide and Dexamethasone in decreasing of postoperative mausea and vomiting was significant (P<0.05). The 24 hour following of nausea and vomiting, also had the same results. Conclusion: With regrard to the results of this study, implication of the combination of 10mg metoclopromide and 8mg Dexamethasone before the induction of anesthesia remarkably decreased the rate of postoperative nausea and vomiting and is useful for the high risk groups for this complication especially in out patient surgery.
Masoud Entezariasl, Ghodrat Akhavan Akbari , Khatereh Isazadeh Far,
Volume 7, Issue 4 (12-2007)
Abstract
Background & Objective: With consideration the daily increased development of outpatient surgeries and high rate of these operations in elderly patients, rapid and safe recovery of patients for coming back to daily life is necessary. In this clinical trial study recovery time and nausea and vomiting after the use of two rapid-onset narcotic, alfentanil and remifentanil in elderly patients has been compared. Methods: In this double-blind clinical trial 40 elderly patients (age above 65) candidated to cataract surgery with general anesthesia were studied. The patients were divided randomly into two groups and for first group alfentanil was injected 10 m g/kg and for second group remifentanil 0.5 m g/kg during 30 seconds one minute before induction. Both two groups were under general anesthesia with same method and during the anesthesia first group took infusion of alfentanil 1 m g/kg/min and second group remifentanil 0.1 m g/kg/min. At the end of surgery the time intervals between end of anesthesia drug adminstration and autonomic respiration, eyes opening with stimulation, verbal response and discharge of recovery room, also the incidence of complications related to narcotic drugs especially nausea and vomiting were recorded. The data were analyzed in SPSS software using descriptive and analytical statistics as T-test, chi square and ANOVA. Results: The time of autonomic respiration in alfentanil group was 2 minutes and in remifentanil group 3.3 minutes,this time in alfentanil groupe1.3 minutes shorter but the difference was not significant. The time of eyes opening with stimulation, verbal response and discharge of recovery room were not significantly different. During recovery incidence of nausea and vomiting in remifentanil group (30% of patients) was significantly more than alfentanil group (5% of patients) (P<0.05). Conclusion: The time of recovery between alfentanil and remifentanil group was not significantly different, but incidence of nausea and vomiting in remifentanil group was higher than alfentanil group significantly.
Ghaffar Shokouhi , Amirziya Alimoradi , Eiraj Lotfinia, Mohammad Asgari , Mohammadhosein Dagigi , Masood Pourisa ,
Volume 8, Issue 2 (6-2008)
Abstract
Background & Objective: Determining the level of lesion in lumber disc disease might be difficult, especially when there is a transitional vertebrae. MRI is one the methods widely used in presurgery however, presence of sacralization or lumbarization may lead to a incorrect diagnosis. This study aimed at evaluating the agreement degree between the results of MRI and surgery with the post-operative radiographic findings in patients with lumber disc herniation. Methods:Thirty patients with lumber disc herniation were evaluated in a diagnostic value study during a 15-month period of time. Presurgery MRI results, as well as the findings during operation regarding the level of herniated lumbar disc were compared with the radiographic findings, numbering the vertebra below the C2 after surgery. The radiologic assessment of involved segment was considered as the gold standard method. Transitional vertebrae were determined on the basis of radiologic findings. Results:There were thirty patients with lumber disc herniation, 16 males and 14 females, with the mean age of 40.83±12.57 years in the study. There was a high and significant degree of compatibility agreement between the results of MRI and findings during surgery with the radiologic data (kappa=0.719, p<0.001 kappa=0.859, p<0.001). The results of MRI and surgery were incorrect in 4 and 2 cases, respectively. All these cases had a transitional vertebra in lumbosacral segment (totally 6 patients with transitional vertebra) i.e. MRI and surgery were able to detect the right level of herniation in 33.3% and 66.7% of patients with either sacralization or lumbarization, respectively. The sensitivity of MRI and surgery was 87% and 93%, respectively. Conclusion:Our results showed that MRI and surgery can reveal the right level of LDH in majority of patients however, when there is a transitional vertebra, this ability may significantly be decreased.
Mir Mohammad Taghi Mortazavi, Masoud Niazi, Naser Rezapour, Masoud Parish,
Volume 15, Issue 4 (1-2015)
Abstract
Background & objectives: Surgery of upper part of femor in elderly patients can be due to the fracture of femoral neck, shaft and arthroplasty. Hemodynamic changes and complications of the anesthesia are among the major concerns. The aim of this study was to compare the hemodynamic changes in low dose isoflurane with propofol in upper femoral surgeries in elderly patients.
Methods: This prospective clinical trial study was done on 60 patients over 65 year-old elderly patients with ASA physical status of I and II that were candidate for upper femoral surgery in two groups (inhalational: isoflurane 0.5-0.6 MAC) and (total intravenous anesthesia with propofol 50-100 mic/kg/min). Hemodynamic changes were compared in these groups with the same anesthetic depth (HR-SBP-DBP-MBP-SaO₂).
Results: There was no significant difference in heart rate, age or sex between two groups. In isoflurane group SBP on 20 and 25th minutes and DBP and MBP on 20, 25 and 35th minutes were significantly higher than propofol group. In propofol group SaO₂ was significantly more than isoflurane group on induction, start of surgery and on 5, 25, 35 and 45th minutes of surgery.
Conclusion: In anesthesia with the same Bi-Spectral Index, isoflurane provides more stable hemodynamic parameters than propofol.
Alireza Mohammadzadeh, Farshad Tofigi, Hasanpour Hasanpour, Khatere Isazadehfar,
Volume 16, Issue 1 (4-2016)
Abstract
Background & objectives: Cardiac arrhythmia after CABG surgery is a common complication which results in other side effects. Therapeutic effect of prophylactic magnesium administration is controversial and there are many different ideas in this case. The aim of this study was to evaluate the therapeutic effects of magnesium in reducing cardiac arrhythmia after CABG.
Methods: The clinical trial enrolled 140 patients undergoing CABG. Based on the initial blood levels of magnesium, patients were divided into two groups, one group with low serum magnesium and the other group with normal one. The low serum magnesium group treated with magnesium preoperatively and had normal serum magnesium level before operation. Postoperatively, both groups were randomly divided into two sub-groups, one receiving 2 gr. of magnesium sulfate and the other group received placebo. Both groups monitored for occurrence of arrhythmia in the ICU – OH for 3 days. Data were analyzed with statistical methods. P value of <0.05 was considered statistically significant.
Results: The results showed that the occurrence of arrhythmia in any of the sub-groups was not significantly different from each other (p> 0.05). There was no significant relationship between blood levels of magnesium and arrhythmia at different days (p> 0.05).
Conclusions: Blood level of magnesium and prophylactic magnesium administration have not effect on reducing arrhythmia after CABG surgery. The highest incidence of arrhythmias happened in the hypomagnesium group without prophylaxis on the third day after surgery, but this difference was not statistically significant.
Iraj Faizi, Saeid Smaeilpour, Ali Nemati , Khatere Isazadeh, Farideh Faizi, Vahid Montazeri,
Volume 17, Issue 3 (10-2017)
Abstract
Background & objectives: The use of supplements such as L-carnitine, optimum nutritional support and early feeding after surgery in cancer patients can be important in the prevention of cancer complications. The aim of this study was to determine the effects of early L-carnitine-rich feeding on complications of esophageal cancer surgery and duration of hospitalization.
Methods: In a clinical trial, 50 patients with esophageal cancer under surgery in two equal groups were randomly selected. Nutritional information was obtained using food record questionnaire. Basic blood samples and 24-hour urine samples were taken in order to measure the hematological parameters (like blood cell count, hemoglobin, hematocrit and blood urea) and nitrogen balance, respectively from two groups at the beginning and end of the study. Then, the intervention group received 3 g L-carnitine daily in 3 doses on the first day after the complementary operation, with a routine hospital diet at each meal, and the control group received a routine hospital diet for ten days. Data were analyzed using independent t-test, paired t-test and chi-square test.
Results: The results showed that changes in the mean BUN and nitrogen balance were significantly different after intervention between the study groups (p<0.05). Patients with early L-carnitine-rich feeding had less hospitalization time in hospital wards and were discharged earlier (p<0.05).
Conclusion: The results of this study showed that early L-carnitine-rich feeding after surgery has probably a positive effect on the duration of hospital stay in patients with esophageal cancer.
Dr Yousef Fekri, Dr Habib Ojaghi, Dr Telma Zahirian Moghadam, Dr Afshan Shargi, Dr Arezoo Ranjbar, Talma Zahirian Moghadam ,
Volume 20, Issue 1 (4-2020)
Abstract
Background & objectives: Cataract is the most common cause of blindness in the world and it is estimated that about 100,000 cataract surgeries are performed annually in Iran. The aim of the present study was to determine the prevalence of different morphological types of cataract and some related causes in patients undergoing surgery at Noor Surgery Center in Ardabil.
Methods: This descriptive cross-sectional study was performed on 780 patients referred to the Noor ophthalmology clinic in Ardabil with cataract diagnosis. The data were collected using a checklist by the researcher. Data analysis was performed using SPSS 25 software and descriptive statistical methods.
Results: Of the 1,018 eyes (780 patients), 590 eyes (58%) were related to women and 428 eyes (42%) were related to men and the mean age of all patients was 65.88±11.43. the mean grade of posterior subcapsular cataract (PSC), nuclear and cortical cataracts were 4.56±0.62, 4.79±0.89 and 4.21±0.48 respectively. There was a significant difference between normal retina diabetics (p=0.034), pseudo exfoliation syndrome (PEX) (p=0.001), hyperopic (p=0.008), corneal opacity (p=0.036) and patients with nasolacrimal duct obstruction (NLDO) (p=0.032) and other patients in terms of cataract type (p=0.034). There was no significant relationship between other comorbidities and cataract type.
Conclusion:According to the results of the present study based on the significant relationship of some diseases with different morphological types of cataracts, accurate preoperative
evaluation and planning for associated comorbidities is recommended.
Ali Alizadeh, Hamid Kayalha, Zohreh Yazdi, Aidin Binazadeh, Shahram Rastak, Mohammad Sofiabadi,
Volume 20, Issue 1 (4-2020)
Abstract
Background & objectives: The use of controlled hypotension is important to reduce bleeding in some surgeries. This study aimed to determine the effects of dexmedetomidine (DEX) and labetalol for induced hypotension in maxillofacial fractures surgery.
Methods: In this triple-blind randomized controlled clinical trial study, the patients with maxillofacial fractures were randomly divided into two groups: group 1. Dexmedetomidine (DEX) (bolus dose: 1μg/kg and maintenance dose: 0.3-0.5 μg/kg/h) and group 2. Labetalol (bolus dose: 0.3mg/kg and maintenance dose: 0.2-0.5 mg/kg/h). The patient's hemodynamic indices (including heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean arterial pressure (MAP) were recorded at various surgical intervals. Finally, the surgeon's satisfaction (from 1-6 points) was evaluated. Data were analyzed using SPSS 19 software.
Results: The MAP, SBP, and DBP were significantly higher in the DEX group than the Labetalol group especially at 30 and 90 minutes after the bolus. The mean HR was significantly lower in the DEX group than Labetalol during the recovery period. The surgeon's satisfaction in the Labetalol group was significantly higher than the DEX group.
Conclusion: Based on the results, labetalol offers a better hemodynamics conditions than DEX during surgery and also lead to greater overall surgeon satisfaction.
Amirahmad Arabzadeh, Ghodrat Akhavan Akbari, Iraj Feizi, Afshan Sharghi, Mahboubeh Taghipour Moazen, Bita Shahbazzadegan,
Volume 21, Issue 1 (4-2021)
Abstract
Background & objectives: Using medications that decrease postoperative pain and opioid consumption is a widely recommended approach. The aim of this study was to evaluate the efficacy of intravenous Ibuprofen and its complication in controlling pain after abdominal surgery.
Methods: This study was a randomized, double-blind, interventional clinical trial. Sixty patients aged 20 to 60 years were candidates for abdominal surgery (inguinal hernioplasty and appendectomy). Patients were divided into two equal size groups (n=30) using a random block design method. The First group received (400 mg IV) ibuprofen every 6 hours for 24 hours as well as (15 microgram/ml bolus) fentanyl pump with PCA. Second group only received (15 microgram/ml blous) fentanyl pump with PCA.
Results: Demographic characteristics and duration of surgery, ASA class, type of anesthesia and type of surgery were similar in the two groups. Pain severity in 24 postoperative hours was significantly lower in the ibuprofen group compared with the control group. Nausea and vomiting frequency in 24 postoperative hours was significantly lower in the ibuprofen group compared with the control group. Patients belonging to ibuprofen group were significantly more satisfied with their analgesic method.
Conclusion: Results showed that using 400 mg intravenous ibuprofen every 6 hours mitigates postoperative pain, reduces fentanyl consumption and is highly tolerated by patients.
Mohammad Hassanpour, Vahid Adiban, Firouz Amaani, Ahad Fatehi,
Volume 22, Issue 2 (7-2022)
Abstract
Background & Objective: Bleeding is a common complication during heart surgery, and management of heparin and protamine consumption during operation affects hemeostasis. The dosage of protamine sulfate is variable based on the amount of heparin used and studies have reported different results. The aim of this study was to evaluate the effect of protamine sulfate administration after cardiac surgery on the drainage of the patient's blood secretions.
Methods: In this retrospective cross- sectional study, required data from 120 medical records patients, from 2011 to 2020 undergoing heart surgery, for example CABG, was extracted and examined. Patients were grouped (60 people in each group) and compared based on protamine sulfate intake and not receiving it, in the intensive care unit and body mass index, age, sex, ACT values and blood drainage rate.
Results: 76 (63.37%) patients were male and 44 (36.66%) patients were female. Most patients were in the age range of 50-70 years and most patients were overweight. Blood drainage in the protamine group was significantly lower than the control group. There was no statistically significant difference between the two groups in terms of ACT values. Blood drainage in the protamine group was significantly lower in normal BMI and overweight individuals than in the control group. The amount of blood drained in the protamine group in women and in people over 70 years was significantly lower than the control group.
Conclusion: despite previous studies, our study showed a reduction in the amount of postoperative bleeding following re-prescribing of protamine sulfate in the intensive care unit, which eliminated the effect of heparin and the coagulation disorder caused by heparin. The limitations of the present study included patients under 12 years of age, patients weighing more than 120 kg, and patients requiring hypothermia treatment less than 28 Cº.
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