Iranian Journal of Surgery
Year:2023 | Volume:31 | Issue:4|Papers Count:10

Diabetes is a set of metabolic disorders that manifest with increased blood sugar. This is a large pandemic disease that has several hundred million sufferers and a similar number of people at risk, and some people also show a pathophysiology similar to diabetes during injury and severe stress. Diabetic patients require hospitalization and surgery more than other people, and the mutual effects of surgery and diabetes can affect the course of surgery or its complications. Knowing the effects of surgery on diabetes, diabetes and its drugs on surgery and how to manage blood sugar during surgery can be a basis for timely and correct decision making.

Introduction &,Objective: Covid-19 Vaccination in pregnant women may affect the central nervous system of newborn, but this issue has not been confirmed and requires comprehensive investigations. Due to the fact that no comprehensive study has been conducted in Iran to investigate neurologic complications requiring surgery in infants born to women vaccinated with covid-19 vaccines, we decided to conduct this study with the aim of the effect of covid-19 vaccination of pregnant women on the occurrence of neuro surgical requiring intervention in newborns. Materials &,Methods: This retrospective cohort study was conducted with the participation of 718 pregnant women (429 vaccinated and 289 unvaccinated) during the year 2022,Maternal and neonatal complications and complications related to neurological procedures requiring surgery were recorded from the existing information system. Chi-square, t-test, ANOVA and multiple binary logistic regressions were used to compare the data of two groups. Results: Vaccination of Covid-19 in pregnant women leads to an increase in intracerebral hemorrhage (95% CI: 1. 85-3. 77 and (OR=1. 41) and brain cyst (1. 13-13. 96: 95% CI: 1. 55-3. 77 OR=1) in babies born from them. While significant effect on hydrocephalus (OR=0. 91), craniosynostosis (95% CI: 0. 45-0. 96 and OR=0. 88), tubal defect There was no neurological (95% CI: 0. 14-0. 45 and OR=0. 37) and vascular thrombosis (0. 77-0. 97: 95% CI and OR=0. 89). Conclusions: Covid-19 vaccination has been associated with many benefits and has increased public health,However, performing it in pregnant women has been associated with rare complications that were investigated in this study,The results of this study showed that the covid-19 vaccination in pregnant women leads to an increase in intracerebral bleeding and brain cysts in newborns,However, more studies are needed to confirm these results.

Introduction &,Objective: Evidence is accumulating on the efficacy of non-operative management of blunt hepatic and splenic trauma as the treatment of choice in these patients. Materials &,Methods: In this prospective study, our sample comprised of patients referred to the emergency department of Imam Hosein Hospital with blunt hepatic and splenic trauma confirmed by CT-scan and ultrasound. All of the hemodynamically stable patients, with no other indications for laparotomy were monitored in the ICU and managed non-operatively. The management plan changed accordingly in cases that non-operative plan failed. Results: In our subjects, 61(49. 2%), 50(40. 3%) and 13 (10. 5%) had hepatic, splenic and concomitant blunt hepatic and splenic trauma, respectively. Non-operative management succeeded in 103 (83%),in the remaining 21 (17%) patients, older age and higher trauma grades were significantly associated with the failure of non-operative management. Concomitant trauma, particularly head trauma was only significantly associated with the failure of non-operative management in those with blunt splenic trauma. Conclusions: Non-operative management of the blunt hepatic and splenic trauma in hemodynamically stable patients is considered the treatment of choice, with high efficacy and low complications if managed successfully. Yet, due to considerable complications associated with the failure of non-operative treatment, independent prognostic factors that could predict unsuccessful management should be considered in advance by the surgical team. Important predictors of failure are older age, particularly above 55, concomitant trauma, especially to the head and higher grades of trauma.

Introduction & Objective: Falling is considered an accident, it entails a lot of costs and potential wide physical, psychological and social consequences. Activity level and lifestyle changes in the elderly. Considering the importance of falls in the elderly, this study was conducted with the aim of epidemiological investigation of traumatic injuries caused by falls in the elderly. Materials & Methods: The present study was a cross-sectional study that was conducted between 1994 and 1996 on elderly people who referred to the emergency department of Shahid Beheshti Hospital after falling. Sampling was done by census method. The medical records of all patients aged 60 years and older who referred to the emergency department of the mentioned hospital with a history of falls were included in the study. And the studied variables such as age, gender, place of residence, treatment outcomes, place of fall and how the recent incidents were entered into the checklist. Cases with distorted information and cases whose history is incomplete were excluded from the study. Finally, all information was entered into SPSS software version 22 and analyzed with a significance level of less than 0.05. Results: In this study, 182 patients (93.8%) were discharged and 12 patients (6.2%) died. A statistical relationship was found between the average age and mortality after a fall in patients (P < 0.001). But between genders (P = 0.76). Marital status (P = 0.441). The type of fall (P = 0.833), no statistically significant relationship was found with the outcome of the disease. The most type of injury is in the femur and the average duration of hospitalization of these patients is 5 to 7 days, also there are significant statistical differences between the duration of hospitalization and the type of injury (P < 0.001). The most injuries occurred in 90 cases (46.6 percent) between 12-6 AM and these injuries were observed in the femur of 39 patients (20.1 percent). Conclusions: According to the results of the present study, it seems necessary to apply measures to prevent the elderly from falling. A large number of elderly people who have fallen have been admitted to the hospital and a large percentage was hospitalized for a long time, which has brought a lot of costs to the health system. In addition, the need to implement timely measures for treatment, correct management and prevention of the consequences of trauma is felt.

Introduction & Objective: So far, various studies have been carried out in order to design different methods for the construction of the nerve channel with the aim of repairing the nerve tissue. The purpose of this study is nerve repair surgery by making a nerve conductive channel with the aim of self-stimulation. In this study, polycaprolactone (PCL) and polyvinylidene fluoride (PVDF) channel, in combination with polyaniline/graphene nanoparticles (Polyaniline Graphene-PAG) and gelatin, was prepared by a two-way and simultaneous electrospinning approach. Materials & Methods: At first, solutions containing 13% by volume of polycaprolactone and 19% by volume of polyvinylidene fluoride in the common solvent of dimethylformamide (Dimethylformamide - DMF) and acetone were dissolved separately, and then both solutions were mixed together. became In the next step, 28 % by weight and volume of gelatin solution was dissolved in distilled water and acetic acid, and polyaniline/graphene nanoparticles with 0, 1, 2, and 3 percent by weight and volume were homogeneously mixed in the gelatin solution, and then two-way and simultaneous electrospinning process Was performed. Scanning Electron Microscope (SEM) was used to examine the morphology of the fibers. In order to determine the optimal amount of polyaniline / graphene nanoparticles for nerve conduction, electrical conductivity and piezoelectric properties of the fabricated scaffolds were investigated and also the survival percentage of pheocrocytoma cell line (PC12) on the scaffold was calculated. Data were calculated as mean ± standard deviation (Mean ± SD). The significant level of differences was determined to be (P < 0.05). Results: The results was showed that with increasing the percentage of polyaniline/graphene nanoparticles up to 2% by weight, the amount of electrical conductivity and output voltage increased, but at a concentration of 3% by weight, the amount of electrical conductivity and also the output voltage decreased. Scanning electron microscope observations showed that the average diameter of nanofibers decreased up to a concentration of 2% by weight, but at a concentration of 3% by weight of polyaniline/graphene nanoparticles, the diameter of nanofibers increased. Also, the biodegradation of electrospun scaffolds showed that the increase of nanoparticles caused a decrease in degradability. Conclusions: In nerve repair surgery, the presence of polycaprolactone and gelatin along with polyaniline/graphene nanoparticle increased the nerve conduction and also the use of polyvinylidene fluoride in the electrospun scaffold will improve the self-stimulation property in the nerve conduction channel, which can be a suitable substrate for The growth and cell proliferation of the nerve tissue, and hence the probability of success in the surgery increases to its maximum extent.

Introduction &,Objective: Pain and trismus are common complications after mandibular third molar surgery,Preventive methods of these complications are diverse,Recently, the use of fibrin rich in platelets has been effective in several studies, but their results have not been summarized in a review study to confirm or reject its exact effectiveness,Therefore, the present study was conducted with the aim of a meta-analysis on the effect of fibrin rich in platelets on improving pain and trismus after mandibular third molar surgery. Materials &,Methods: In this systematic review and meta-analysis, clinical trial potentially related studies were identified by searching Pubmed, Embase, Cochrane Library, Web of Science, Magiran, and SID. A systematic and comprehensive search was performed in the aforementioned databases using a combination of medical keywords and subheadings: platelet rich fibrin or PRF, oral and third molar surgery, pain, trismus, postoperative and postoperative complications. Weighted mean difference (WMD) of continuous variables with the same unit (standard mean difference (SMD) (continuous variables with different units) and 95% confidence interval for continuous data and risk ratio (RR) were calculated and 95% CI for Double calculated. Results: 6 studies that included the results of postoperative pain in patients who received platelet-rich fibrin with the control group were included in the meta-analysis. A significant difference was observed in postoperative pain on the third day between the two groups (SMD = 0. 53, CI95%: 0. 1-05.-RR: 02-I2 = 75. 75 and P = 0. 001),A significant difference was observed in postoperative trismus on the first day between the two groups (SMD = 0. 55, CI95%:-0. 1-0. 08: RR: 0. 001-I2 = 0. 01 and P = 0. 01). Conclusions: Based on the results of the present study, it was found that platelet-rich fibrin only reduces some postoperative complications, but does not prevent them. Platelet-rich fibrin significantly relieved pain, swelling after third molar extraction,Therefore, further studies with larger data sets and high-quality studies are necessary to confirm the current findings.

Introduction &,Objective: Early detection plays a vital role in improving the outcomes of patients with gastric cancer. However, identifying the disease during its early stages is challenging due to the lack of specific symptoms. Presentation of Case: This case report presents a patient with gastric cancer and liver metastasis who remained asymptomatic despite the advanced disease. The patient initially presented with acute abdominal right upper quadrant pain, leading to various diagnostic investigations, including ultrasound, CT scan, MRI, and upper gastrointestinal endoscopy. The imaging and pathological findings confirmed the presence of a metastatic liver mass and a large fungating mass in the stomach with the pathology of an adenocarcinoma after endoscopic biopsy. Surgical intervention was avoided due to distant metastasis. The patient underwent FOLFOX (folinic acid, fluorouracil and oxaliplatin) chemotherapy regimen. Results: This case highlights the importance of considering gastric cancer in the differential diagnosis of patients presenting with unexplained abdominal pain without typical symptoms. Conclusions: A multidisciplinary approach involving various medical specialties is necessary to ensure early diagnosis and appropriate treatment for metastatic gastric cancer.

Introduction &,Objective: With the many advances that have taken place in the field of surgery and the possibility of transplanting organs in recent years, an important issue has been raised in the field of punishments such as limb retribution and also the punishment of limb amputation in the case of robbery with the limit of Had or Moharebeh, whether the victim can transplant the limb after the crime has occurred. Make it a crime? It is also for the perpetrator, does he have the possibility and permission to replace the severed limb after execution of retribution or amputation? Materials &,Methods: With the aim of obtaining answers to the above questions, the present research seeks to provide appropriate answers to the challenges that arise in the jurisprudence surrounding the issue by searching in various jurisprudential and legal sources. Results: From the point of view of medicine, organ transplantation can be applied in several ways, human to human, animal to human, and corpse to human. From the point of view of jurisprudential sources, there is no strong reason or reference to reject these actions, and each of the jurists have presented different opinions in this regard, but the famous jurists have given permission to organ transplantation in the above cases. Conclusions: Organ transplantation is one of the valuable services that have been achieved for mankind in the shadow of the advances in medical science. In addition to these achievements, it is necessary that the jurisprudential and legal aspects of organ transplantation are explicitly legislated so that people in the society can benefit from such measures in order to treat and save their lives.