JOURNAL OF RESEARCH IN MEDICAL SCIENCES (JRMS)
Year:2018 | Volume:23 | Issue:9|Papers Count:7

One‑ anastomosis gastric bypass is an attractive bariatric procedure. It is effective in weight loss and comorbidity resolution. It is a relatively simple and fast operation with low complication rates that make it a suitable option in super‑ obese individuals. Although not proven yet, there are some concerns about its long‑ term safety profile in terms of biliary reflux, marginal ulcer, and esophagogastric malignancy. In this article, we review the technique of this procedure and discuss about some practical surgical highlights. Furthermore, we overview studies performed about this procedure and compare it to some other well‑ established bariatric operations, while providing a detailed study about the facts related to its outcomes and complications.

Background: The pathogenesis of ventilator‑ associated pneumonia (VAP) is not clearly known. Recently, the role of gastric bacterial colonization has been proposed. The role of gastric colonization with Helicobacter pylori in pathogenesis of VAP was determined by comparing the prevalence of H. pylori in patients with VAP and control participants. Materials and Methods: One hundred and eighteen mechanically ventilated patients were divided into two groups; 59 participants with VAP and 59 without VAP. Serologic tests for H. pylori were registered. Results: Mean age in seropositive patients was significantly higher. About 71. 2% in VAP group and 61. 01% in controls were IgG seropositive (P = 0. 24). IgM seropositivity was 23. 73% versus 8. 47% in VAPs and controls, respectively (P = 0. 024). By increasing the time of intubation, more patients became seropositive for IgM (Pearson’ s correlation coefficient = 0. 4, P = 0. 002). Conclusion: IgM seropositivity and serum levels were significantly higher in VAP patients. Furthermore, by increasing the duration of intubation, serum levels for IgM increased significantly.

Background: Pathologic scarring is a common problem after burn injury that has functional and esthetic limitations. Conservative and surgical treatments available for these scars are not always satisfactory. Extracorporeal shock wave therapy (ESWT) is a noninvasive modality that has proven positive effects on burn scars and wound healing in few studies. This study was conducted to evaluate the effects of ESWT on improving burn scar in extremities. Materials and Methods: This study was a prospective quasi‑ experimental on burn patients with burn scar in their extremities that underwent ESWT sessions once a week for 6 weeks. For evaluating pain and itching, visual analog scale (VAS) and for scar appearance, Vancouver Scar Scale (VSS) were used. These scales were measured and compared at the beginning of the treatment, at the end of the treatment, and 1 and 3 months after the end of the intervention. Results: In this study, 17 patients were treated with ESWT with a mean age of 37. 94 ± 7. 25 years that 47. 1% of them were male. The mean of VAS score for pain and itching and VSS score were decreased significantly after the treatment and during follow‑ ups (All P < 0. 001). Conclusion: ESWT can improve the pain, itching, and appearance of the burn scar in human extremities in burn patients.

Aluminum phosphide (ALP) poisoning is one of the fatal poisonings in the world. Hemolysis is a rare presentation of this poisoning. Here, we report an episode of hemolysis due to G6PD deficiency after ingestion of ALP and also the patient survived.

Background: Blood transfusion is essential in severely ill patients whose hemoglobin (Hb) levels are low, but there are some factors that inhibit optimal increase in Hb. The aim of this study was to evaluate the amount of increase in Hb levels after packed red blood cell (PRBC) transfusions in the Intensive Care Unit (ICU) patients and its related factors. Materials and Methods: This cross-sectional study included 124 patients admitted to the ICU, and needed PRBC transfusion. Demographic information, Hb on the 1st day of admission, blood volume transfusions during the 7 days, and the 7th day of admission Hb level were extracted from patients’ records. Results: The average initial Hb level of patients was reported as 6. 17 ± 1. 43 g/dl, and after administrating PRBC (4. 23 ± 1. 87 units during 7 days), the Hb level was 8. 09 ± 1. 66 g/dl after 7 days (mean difference was 1. 91 ± 1. 93, t = 11. 06, P < 0. 001). No significant differences were found between change in Hb level in the terms of age, gender, underlying illness, body mass index, hospitalization history, fever, and duration of hospitalization (P > 0. 05). However, the mean increased Hb level in hospitalized patients with internal disorders was the lowest (0. 25 g/dl, P = 0. 002). Conclusion: The results of our study showed that the increased Hb level based on one unit of received PRBC was low, especially in patients with internal. Therefore, based on high frequency of anemia in ICU patients and relative complications, physicians should pay attention to factors affecting Hb levels after PRBC transfusion such as medical history.

Background: Awareness of the trends of cancer incidence in each geographic region is an important. The aim of present study was to determine the incidence trends of cancer in Chaharmahal and Bakhtiari (Ch and B) province in Southwest of Iran. Materials and Methods: In this secondary data analysis, retrospective existing data were used from cancer registry reports in Ch and B in Southwest of Iran in 2003– 2016. Data on epidemiologic trend were analyzed using Joinpoint software package and annual percentage change (APC) with 95% confidence interval (95% CI) was computed. Results: Age‑ standardized incidence rate per 100, 000 persons in the province in 2003 was 31. 74 that increased to 147. 14 in 2016. APC during 2003– 2016 was 12. 58% (CI: 9. 3– 16) and significant, which was 10. 22% (7. 4– 13. 1) and 14. 47% (10. 2– 18. 9) in men and women, respectively. Incidence of the stomach, breast, colorectal, thyroid, lymph node, and ovarian cancers is increasing and the highest incidence was observed in two age groups of 25– 34 and 55– 64 years. Conclusion: In general, cancers are of increasing trend. Surveillance and monitoring the incidence of cancer and studying the causes of environmental or genetic in the cancer changes can help for cancer prevention and control.

Background: The present study aimed to investigate the effects of serum beta‑ 2 microglobulin (B2M) on the risks of major cardiovascular events (MACEs) and all‑ cause death in Chinese elderly isolated systolic hypertension (ISH) patients without severe renal insufficiency (estimated glomerular filtration rate [eGFR] <30 ml/min/1. 73 m2). Materials and Methods: Serum B2M concentration, creatinine‑ eGFR, and blood pressure variability were evaluated in 460 elderly patients (mean age, 82. 6 years; 28 women) with ISH in this observational study. The Cox proportional hazard model was adopted to calculate adjusted hazard ratios (HRs) of risk factors for cardiovascular events and all‑ cause deaths. Results: During a median follow‑ up period of 37. 6 months, 63 patients (13. 7%) died, and 65 patients (14. 1%) had MACEs. Multivariable analysis showed that the higher serum B2M concentration (B2M ≥ 0. 28 mg/dl) was an independent predictor of increased risk of MACEs (nonfatal acute myocardial infarction, acute heart failure, ischemic stroke, and cardiovascular deaths) and all‑ cause death (HR: 2. 62, 95% confidence interval [CI]: 1. 46– 4. 69, P = 0. 001 and HR: 3. 40, 95% CI: 1. 78– 6. 48, P < 0. 001, respectively) adjusting for other multiple confounders including creatinine‑ eGFR and cystatin C. In addition, blood pressure variability derived from ambulatory blood pressure measurement was not associated with incidence of MACEs and all‑ cause mortality (P > 0. 05). Conclusion: Our data suggest that serum B2M concentration may be individually associated with MACEs and all‑ cause death in elderly ISH patients without severe renal insufficiency even after adjusted for creatinine‑ eGFR and cystatin C.