Iranian Journal of Surgery
Year:2018 | Volume:26 | Issue:2 |Papers Count:17

Acid throwing as a formidable violence is more common in countries such as India، Bangladesh، Cambodia and Pakistan. There is a close connection between acid throwing crime and the social status of women. Regarding the irreparable damage of this crime and، more importantly، destroying the beauty of the victim's face، for some people، it is even heavier than the offense of intentional murder. Since acid throwing has been spread in Iran in recent years، a comparative study of punishment of this crime in Iran with these four countries، according to their legal system، appears to be useful. Therefore، type، quality and quantity of punishment and penalizing the criminal can be helpful in better understanding of criminal law، using strengths and covering weaknesses in legislation. According to the results of this study، there is no enough standard law in this country to deter acid throwing. Accordingly، its production، distribution and sale should be limited and preventable، and its illegal distribution must be punished. Since acid throwing is rarely fatal but causes serious damage to one's appearance and beauty، death penalty is rarely imposed. It is important to note that acid burn is a lifelong disease therefore criminal must incur all of conventional expenses of victim for a lifetime in addition to the wergild.

Introduction & Objective: One of the proper methods to reduce the complications of spine surgeries and to accelerate the patient's recovery process is to use methylprednisolone before, during or after surgery. The aim of this study was to investigate the effect of prophylactic administration and high dose methylprednisolone on the prognosis of surgical intervention in patients with cervical myelopathy. Materials & Methods: The study was a randomized controlled clinical trial in patients with cervical myelopathy. Patients with myelopathy who had a surgical indication were included in the study due to spondylosis, degeneration of the cervical intervertebral disks, osteophytes, calcification of the posterior longitudinal ligament, thickening of the ligamentum of flavum, hypertrophic osteoarthritis and other non-traumatic pathologies. In one group, methylprednisolone was injected at high dosages of 12. 5 mg/kg intravenous infusion within 30 minutes, and then (after half an hour) at a dose of 1 mg/kg/hr in the form of continuous intravenous infusion (to the end of surgery). In the other group, this injection was not performed. Before and after surgery (four times: 48 hours, two weeks, one month and six months later), the patients were examined by the team and scored in terms of Japanese Orthopedic Association Score (JOA) and Modified Rankin Scale (MRS). The efficacy of high doses of methylprednisolone was compared by comparing the patients' score before and after surgery in two groups. Results: 72 patients participated in this study. 34 patients were injected with methylprednisolone and 38 patients remained in the control group. There was no significant difference between JOA and MRS scores before and at different postoperative times between the two groups. Post-surgical complications were not significantly different between the two groups. Conclusions: There was no significant difference between two groups in terms of intraoperative variables such as bleeding and surgical time, as well as post-operative complications such as surgery site infections and deep vein thrombosis. Finally, according to the findings of the study, it can be argued that the administration of methylprednisolone during surgery cannot contribute to the improvement of neurological function.

Introduction & Objective: There is frequent patient complain after crooked nose rhinoplasty operations even in apparently straight noses due to remnant of nasal deviations or asymmetries. Authors believe that middle vault skeletal asymmetry can be the source of these deformities. Introducing a practical classification and addressing the corrective plan for each class may help the surgeons to produce more straight noses post-operatively. Materials & Methods: Fifty-one rhinoplasty cases were selected randomly. Pre-operative pictures of faces and intraoperative pictures of upper lateral cartilages before and after separation from septum were taken. Hundred and two upper lateral cartilages were analyzed for shape, size and curvature of horizontal and vertical sub-units. Results: Five different shapes were found so we divided them to 5 groups according to topographic characteristics of each cartilage. Conclusions: This pragmatic classification will help the surgeon to be more concern about the middle vault and will have a plan to correct each variation.

Introduction & Objective: The choice of surgical procedure for inguinal hernia repair is one of the topics discussed in surgery. In this regard, recognizing the efficacy and complications of each of these methods, especially in comparison with each other, can be helpful. Therefore, the aim of this study was to investigate an inguinal hernia recurrence treated with the method of modified repair with the mesh. Materials & Methods: Patients with inguinal hernia underwent inguinal hernia (neuralgia) by the method Proline mesh repair without opening the transversalis fascia cortex during 2006 to 2011, were included in the study. Hernia recurrence cases (with the criterion of a patient's complaining of the return of symptoms in the appearance and examination of the physician and seeing the protrusion of the area in the look and the palpable cases of hernia in the examination by hand) were recorded by the mention of the recurrence period. All patients referred to the inguinal hernia who had undergone an inguinal hernia repair surgery were male. Results: In this study, 126 patients with inguinal hernia underwent inguinal hernia repair surgery were examined. The mean age of the patients was 51. 22 ± 14. 61, which was at least 18 and was at most 96 years. The follow-up study showed no recurrence in the studied patients. Conclusions: According to the results of this study, no cases of recurrence in an inguinal hernia repair method have been seen with the method of modified repair with the mesh.

Introduction & Objective: Caesarean section is the most common method of termination of pregnancy. In this case, the choice of a low-risk, desirable, and affordable anesthetic technique for mother and baby is important. Based on valid studies, the preferred method for cesarean section is spinal anesthesia. However, the results of studies conducted in Iran have confirmed the high use of general anesthetic technique for performing cesarean section. Therefore, the aim of this study was to investigate the causes of non-acceptance of spinal episode in cesarean section by pregnant women. Materials & Methods: This descriptive cross-sectional study was performed on all pregnant women referred to al-Zahra hospital in Rasht, Iran, in 2017, for elective cesarean section. After obtaining informed consent from the subjects, a questionnaire consisting of demographic characteristics and questions about the reasons for not choosing the method of spinal anesthesia was conducted as a face-to-face interview with a trained technician. Finally, the data were analyzed using SPSS 21 software and appropriate statistical methods. Results: In this study, 386 pregnant women with a mean age of 30. 09 ± 6. 31 years and mean pregnancy rate of 2 ± 0. 7 years were studied. Anxiety from back pain, seeing and hearing in the operating room needle stick pain" were the most common causes of non-acceptance of spinal anesthesia. Also, statistical significance was found between the education level of pregnant women and anxiety of the back pain" (P ˂ 0. 0001), “ seeing and hearing in the operating room" (P = 0. 014), headache "(P = 0. 009). A statistical relationship between anxiety about back pain", " anxiety for paralysis", " anxiety to see and hear in the operating room", ", headache, needle insertion pain" and pain during surgery"(P = 0. 0001 in all cases). Also, there was a statistically significant correlation between the history of spinal anesthesia in pregnant women and "anxiety of back pain, paralysis and headache" was observed (P = 0. 42, 0. 027 and 0. 03, respectively). Conclusions: Anxiety from back pain, seeing and hearing in the operating room and needle stick pain" were the most common causes of spinal anesthesia refusal. Enough attention and attempt to relief pregnant women in preoperative visits are recommended. In addition future multicenter studies involving private wards should be planned.

Introduction & Objective: The purpose of this study is assessing Effect of 5s discipline on quality on efficiency of employees and organizational culture in Surgical environments in state hospitals. Materials & Methods: This study is descriptive both in applied target and data collecting. Statistical society in this study includes all of employees in the local branch of the centre of science and technology which is 200 people. Because statistical society is limited and all of them were available, the whole society was studied to achieve a certain result and no special sampling was needed. Questionnaire was data collection tool and Descriptive statistics indexes, mean and Standard deviation, were used to analyse study’ s default assumptions. Also Inferential statistics and specialy dependent T test was used in order to measure amount of 5s discipline on quality of services, efficiency and organizational culture. Results: Results showed a meaningful difference between using and not using 5s discipline on quality of services in the local branch of the centre of science and technology. Results of third assumption shows that application of discipline system has a significant effect on efficiency and organizational culture. Conclusions: The results of the findings showed that the surgical environments that use the S5 adornment system have had a significant impact on their quality, productivity and organizational culture. Therefore, the necessity of using the 5s system of adornment, especially in the operating room environment, is strongly recommended.

Pulmonary arteriovenous malformation (PAVM) is a rare clinical condition with abnormal direct communication between the branches of pulmonary artery and vein. We present a case of PAVM in the central part of right lower lobe in a 43-year-old man, which was successfully treated by lobectomy. Advances in interventional radiology have led to the introduction of obliterative techniques for the treatment of PAVM. However, in the presence of a large solitary malformation centrally located, as in our case, and also in high-risk patients, surgery is still safe and the first effective option.

Penetrating cardiac injury is one of the most life – threatening conditions. Most patients die before reaching the hospital and those that arrive alive must receive immediate surgical intervention. We report the case of a 28-Years old male with penetrating chest trauma. This case was presented with symptoms of cardiac tamponade and diagnosis during the operation was ruptured left ventricle apex.

Cosmetic surgery as one of the ways of plastic surgery following expansion of compensatory surgery that initially was being used as means of fixing damaged or unusual body parts has been center of attention following changes in the lifestyle and social values. Therefore, various ideas about howness of surgeon’ s penal responsibility have been presented about these surgeries. It is acknowledged that the root of most crimes and consequent casualties of cosmetic surgery is disobeying the conditions of amnesty from penal responsibility in Islamic punishment laws. Consequently, cosmetic surgeon according to article for shirking responsibility must first clarify the necessity of doing it according to dangers concerning the surgery, then acquire conscious consent of the patient, and the surgeon's expertness over his field must be observed and according to unnecessaryness of surgery and lack of evidence and necessity, maximum facilities and tools must be used during the procedure. Also avoidance in cosmetic surgery can't change proving it and if crime is committed, culpritness of surgeon would be enough to accuse the surgeon; therefore, he has to be able to prove all of his duties including balance between pros and cons of surgery, notifying the patient, and maximum observance of technical and scientific standards to governmental system.