Case reports
Peyman Virani; Ali Farbod; Mahshid Dehghan; Aisan Akhgari
Volume 24, Issue 2 , 2022
Abstract
Introduction: Damage Control Laparotomy (DCL) is an appropriate technique in approaching patients with critical injuries.
Case Presentation: We report a case of road traffic injury in a 20-years-old male presented with penetrating abdominal trauma caused by a metal tube. The DCL was performed and the ...
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Introduction: Damage Control Laparotomy (DCL) is an appropriate technique in approaching patients with critical injuries.
Case Presentation: We report a case of road traffic injury in a 20-years-old male presented with penetrating abdominal trauma caused by a metal tube. The DCL was performed and the patient was stabilized. Re-exploration was carried out and the patient was discharged on the 33rd day with peroneal nerve palsy and no other associated complications.
Conclusion: Three main causes of mortality in severely injured patients are coagulopathy, hypothermia, and metabolic acidosis. These factors make a vicious cycle that leads to metabolic status disruptions and a high rate of mortality. The DCL consists of an initial laparotomy that is limited to the control of hemorrhage and contamination, followed by intra-abdominal packing. Minimizing the first operation to vital tasks can save lives that may be lost otherwise.
Case reports
Mohammad Faraji; Mahdi Sonei; Fatemeh Sadeghi Ardakani; Mojgan Mahmoudian Targhi
Volume 24, Issue 2 , 2022
Abstract
Background: Cystic meningioma is a rare subtype of meningioma. Various brain tumors may mimic cystic meningioma in imaging appearances.
Objectives: Herein, we reported a series of cases with cystic meningiomas primarily misdiagnosed as pilocytic astrocytoma due to a similar radiological appearance.
Methods: ...
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Background: Cystic meningioma is a rare subtype of meningioma. Various brain tumors may mimic cystic meningioma in imaging appearances.
Objectives: Herein, we reported a series of cases with cystic meningiomas primarily misdiagnosed as pilocytic astrocytoma due to a similar radiological appearance.
Methods: This case-series study included 20 patients with cystic meningiomas admitted to the Ghaem Hospital, Mashhad, Iran, between 2012 and 2019. The findings of magnetic resonance imaging (MRI), computed tomography, and neurological examination were recorded preoperatively. All patients underwent surgery, and biopsies were obtained, confirming the histopathological diagnosis of the tumor.
Results: The patients mean age was obtained at 40.7±12.5 years, and 11 and 9 subjects were men and women, respectively. Most of the patients presented with headaches (50.0%), and hemiparesis (60.0%) was the most found in the neurological examination. The results of all neuroimaging studies revealed solid-cystic supratentorial tumors, in which cysts were intratumoral, larger than solid components, and eccentric relative to them. Most of the cysts were located in the frontal lobe. The signal intensity of T2-weighted MR images showed hypointense lesions in 25.0% of the cases; however, 45.0% of the patients were hyperintense and 30.0% of them were isointense to grey matter. After contrast injection, the tumors solid and periphery experienced a homogeneous enhancement. The most common histopathological finding was meningothelial cells (30.0%) followed by fibroblastic cells (25.0%).
Conclusion: Cases with an initially diagnosed pilocytic astrocytoma in the imaging can turn out to show cystic meningioma after pathological assessments, which deserves clinicians notice.
Research articles
Nizamettin Kutluer; Serhat Do?an; Ali Aksu; Hakan Ayy?ld?z; Mehmet Kalayc?; Zuhal Karaca Karagoz; Zeynep Ozkan; Burhan Hakan Kanat
Volume 24, Issue 2 , 2022
Abstract
Background: Laparoscopic Sleeve Gastrectomy is the most common type of surgical treatment for morbid obesity. One of the most important complications is leakage from the stapler line. Early detection of a leakage is important in preventing undesirable events.
Objectives: The aim of this study was to ...
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Background: Laparoscopic Sleeve Gastrectomy is the most common type of surgical treatment for morbid obesity. One of the most important complications is leakage from the stapler line. Early detection of a leakage is important in preventing undesirable events.
Objectives: The aim of this study was to evaluate the predictive value of postoperative drain fluid pH on early detection of leakage.
Methods: This study was performed with 63 patients including 33 patients who underwent laparoscopic sleeve gastrectomy for morbid obesity (Group SG) and 30 patients who underwent laparoscopic cholecystectomy (Group LC), as the control group. Fluid sample was obtained after surgery with intra-abdominal drain. The pH value of this fluid was measured using a pH meter at the Ohaus device in the biochemistry laboratory of study hospital.
Results: When the differences in the mean pH values of patients who underwent obesity surgery and gallbladder surgery were evaluated; no statistically significant difference was found between the mean pH value of patients (p: 0.808> 0.05).
Conclusion: None of our patient had leakage and unable to demonstrate how would be the drain fluid pH value if there was a leak, we suggest that drain fluid pH would not be a suitable alarming sign for a leakage in the early period. Because we know that most of the leaks occur at the proximal part of the stomach and that there is more saliva drainage through the line of leakage. Although it is known that the acidic fluid of the stomach can be drained from the same leak in this condition, it is not unlikely that saliva can bring the pH to normal levels. Therefore, if the pH of the drain fluid is close to normal, it is meaning that there is no leakage from the site.
Research articles
Masoumeh Bolandian; Hadi Esmaeili Gouvarchin Ghaleh; Ruhollah Dorostkar; Mahdieh farzanehpour; Bahman Jalali Kondori; Farshad NajjarAsiabani
Volume 24, Issue 2 , 2022
Abstract
Background: Cervical cancer is one of the most common cancers in women throughout the globe. According to reports, currently used cervical cancer therapies are harmful to patients. These treatments have also revealed certain adverse effects that may have a severe impact on the lives of women who are ...
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Background: Cervical cancer is one of the most common cancers in women throughout the globe. According to reports, currently used cervical cancer therapies are harmful to patients. These treatments have also revealed certain adverse effects that may have a severe impact on the lives of women who are afflicted with this kind of cervical cancer. To combat cancer, fewer hazardous anti-tumor therapies are required. Natural products, such as herbal medicine, have been revealed to have a variety of biological impacts. Pistacia atlantica gum extract was tested on the TC1 cell line to see whether it had any anti-proliferative effects.
Objectives: This study aimed to determine the anti-proliferative effect of Pistacia atlantica gum extract on the TC1 cell line.
Methods: Gum extract from dried and milled Pistacia atlantica was analyzed using Gas Chromatography-Mass Spectrometry. The cells were divided into five groups at random, including one for the negative control, one for the positive control, and three for the therapy. Cells from TC1 mice were given the extracts of Pistacia atlantica gum at three different doses (100, 200, and 400 mg/mL). To determine the viability of the cells, reactive oxygen species (ROS) generation, and the concentrations of caspases-3, -8, and -9, researchers used a commercial enzyme-linked immuno-absorbent assay kit.
Results: Results showed that, in comparison to the negative control and most other treatment groups, the Pistacia atlantica gum extract group (400 mg/ml) significantly decreased cell viability (70.138±8.464) and significantly increased apoptosis percentage (71.66±4.041), produced significantly more ROS (15.69±0.799), and significantly increased lactate dehydrogenase release (17.83±0.772) in TC1 cells (P<0.05). In addition, the activity of caspase-8 (0.097±0.007) and caspase-9 (0.065±0.004) increased significantly (P<0.05) in this study.
Conclusion: Our findings indicated that Pistacia atlantica gum extract could drastically decrease cell viability and increase apoptosis in the TC1 cell line, similar to the anti-cancer medication doxorubicin.
Research articles
Mina Mohammady; Maryam Radmehr; Hossein Taherian; Arezoo Tahmourespour; Seyyed Taghi Hashemi
Volume 24, Issue 2 , 2022
Abstract
Background: Pathogen-contaminated surfaces are known to transmit Healthcare-Associated Infections in hospitals and other healthcare facilities. Existing hospital-cleaning procedures alone are not enough to prevent the growth of microorganisms over time. Since copper alloy has inherent and continuous ...
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Background: Pathogen-contaminated surfaces are known to transmit Healthcare-Associated Infections in hospitals and other healthcare facilities. Existing hospital-cleaning procedures alone are not enough to prevent the growth of microorganisms over time. Since copper alloy has inherent and continuous antibacterial properties, copper surfaces offer a solution to complement these procedures.
Objectives: This study aimed to assess the antibacterial effects of copper-coated surfaces on the bacterial burden in the intensive care unit (ICU).
Methods: This clinical controlled trial was conducted in a general ICU. The bacterial burden was measured on five surfaces that were coated with a copper alloy foil (purity 99.94%, 100-micron thickness) and five similar surfaces without the copper coating (n=60 each). The total bacterial burden and the colonization rate of Staphylococci, vancomycin-resistant enterococci, and gram-negative bacilli were measured on different surfaces. The collected data were analyzed using Chi-square or Fishers exact, Shapiro-Wilk, Mann-Whitney, and Kruskal-Wallis tests.
Results: The cumulative bacterial burden was lower on copper-coated surfaces than on control surfaces. The copper-coated surfaces were found to have a significantly (95.96%) lower mean bacterial burden (145.20 colony-forming units [CFU]/100 cm2, n=60 surfaces) than the control surfaces (3,598.74 CFU/100 cm2, n=60 surfaces; P<0.001).
Conclusion: The results of this study showed that placing a copper coating on the surface of five common, highly touched objects in ICU rooms reduced the bacterial burden by 96%, as compared with control surfaces.
Research articles
Hadi Ahmadi Amoli; mohamadreza karoobi; Hossein Zabihi Mahmoudabadi; Saeid Ghorbani; Reza Hajebi; Ehsan Rahimpour; Farzad Vaghef Davari
Volume 24, Issue 2 , 2022
Abstract
Background: Anastomotic leak (AL) is one of the common complications of colorectal surgeries. In COVID-19 pandemic, shortening the hospitalization period seems valuable in reducing postoperative complications
Objectives:. C-reactive protein is valuable in early diagnosis and also exclusion of AL.
Method: ...
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Background: Anastomotic leak (AL) is one of the common complications of colorectal surgeries. In COVID-19 pandemic, shortening the hospitalization period seems valuable in reducing postoperative complications
Objectives:. C-reactive protein is valuable in early diagnosis and also exclusion of AL.
Method: This study was a survey of laboratory tests. The patients were enrolled with the elective of colorectal surgery between 2017 and 2019. We measured the symptoms of Anastomotic leak such as high-level C-reactive protein, leukocytosis, body temperature, and ileus by passing five days from the surgery. Moreover, we evaluated the value of C-reactive protein to exclude Anastomosis leakage within 5 postoperative days.
Results: three hundred and fifteen patients were enrolled in this study. The mean age of the patients was 56.2 years old. Anastomotic leak was detected in 26 patients. C-reactive protein levels in the second day, third day, fourth day, and fifth day were significant for the Anastomotic leak (P-value <0.05). In postoperative days 2 and 4, CPR levels below 44 mg/L and 27.2 mg/L were found to be significant for the exclusion of anastomosis leakage.
Conclusion: Postoperative serum CRP, especially on postoperative days 2 and 4 with cut off value of 44 mg/L and 27.2 mg/L in the absence of ileus, fever, leukocytosis, and normal abdominal examination, could be considered as a highly sensitive adjutant to exclude AL and shorten the hospitalization period.
Research articles
saba alidadi; mahshid mohammadian; reza zohdiaghdam; kosar esgandari; zhaleh behrouzkia
Volume 24, Issue 2 , 2022
Abstract
Background: Colorectal cancer (CRC) is one of the major leading causes of cancer related death throughout the world. Among various therapeutic strategies for CRC, neoadjuvant radiotherapy, targeted therapy, and chemotherapy are the main techniques to destroy cancerous cells.
Objectives: The main purpose ...
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Background: Colorectal cancer (CRC) is one of the major leading causes of cancer related death throughout the world. Among various therapeutic strategies for CRC, neoadjuvant radiotherapy, targeted therapy, and chemotherapy are the main techniques to destroy cancerous cells.
Objectives: The main purpose of this study was to evaluate the efficacy of radiotherapy in combination with silver graphene quantum dot (SQD) and Resveratrol (Res) on the HCT-116 colorectal cancer (CRC) cells.
Methods: Minimally cytotoxic concentrations of SQD (50µm) with Res (0.5xIC50 and 0.25xIC50) and radiation (2Gy of x-ray radiation) were selected for double and triple treatments. The Acridine Orange/Ethidium Bromide staining was used to detect apoptosis. The Caspase-3 mRNA expression level was measured by the real-time PCR method. In addition, cyclooxygenase 2 (COX-2) protein expression was studied by the western blot technique. Similarly, the superoxide dismutase (SOD), glutathione peroxidase (GPX) enzyme activities, and malondialdehyde (MDA) levels were determined in this study.
Results: In this study, after 24 h, triple combined cases showed decreased cell viability versus double and single treatments (P<0.05). Moreover, cellular viability was decreased in the SQD-radiation and SQD-Res treated cells, compared to the related single treatments (P<0.05). The increased apoptotic cells were observed in the triple combination group, compared to the double and single treated cases. Triple combination treatment exhibited decreased GPX activity versus single treatments (P<0.05). The triple combined case showed reduced SOD activity than the radiation and SQD single treatments. A remarkable increase in the MDA concentration was observed in the triple combination versus single treatments. According to the results, in double and triple treatments, upregulation of Caspase-3 mRNA was presented versus double and single treatments. There was a decreased COX-2 protein expression level in triple combinatorial cases versus double and single treated cells.
Conclusion: These findings proposed that SQD in combination with Res and radiation showed significant anti-cancer effects on CRC in vitro.
Research articles
Emine Fusun Akyuz Cim; Esra Torlak; Gizem Unveren; Gursel Remzi Soybir; Vahit Ozmen; Zeynep ErdoGan Iyigun; Tuba Kayan Tapan; Abdullah Yesilova; Gul Alco; Ebru Yilmaz; Asli Eyrenci; Filiz Elbuken; Ahmet Serkan Ilgun; Tomris Duymaz; Cetin Ordu
Volume 24, Issue 2 , 2022
Abstract
Background: Coronavirus disease 2019 (COVID-19) has spread rapidly across the globe through coughing, sneezing, droplet inhalation, and contact.
Objectives: The current study aimed to assess the impact of the fear of COVID-19 infection on functionality in women with breast cancer.
Methods: The present ...
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Background: Coronavirus disease 2019 (COVID-19) has spread rapidly across the globe through coughing, sneezing, droplet inhalation, and contact.
Objectives: The current study aimed to assess the impact of the fear of COVID-19 infection on functionality in women with breast cancer.
Methods: The present study included women with diagnosed breast cancer (n=75) under treatment in Istanbul Florence Nightingale Hospital and healthy (n=69) women( a total of 144 volunteers). The participants were asked to fill out the Sociodemographic Data Form, Anxiety Sensitivity Index-3 (ASI-3), and Fear of COVID-19 Scale to evaluate the impact of fear of infection and cleaning behavior due to COVID-19 on functionality.
Results: No statistically significant difference was found between the women with and without diagnosed breast cancer regarding the impact of fear of COVID-19 infection on all functionality parameters (all parameters: P>0.05). In the breast cancer group, the effect of Covid-15 anxiety and cleaning behavior on functionality performance was significantly higher in participants with underlying disease (P=0.044, P=0.013) and smoking (P=0.0234, P=0.0147).
Conclusion: As evidenced by the results of this study, smoking and the presence of comorbidity in breast cancer patients may have a negative effect on the functionality effect of fear of Covid-19 infection. In terms of psychiatric intervention, the parameters affected by functionality should be considered.
Research articles
Amir Hossein Behnoush; Navid Ahmadi; Mehrdad Mozafar; Seyed Peyman Mirghaderi; Alireza Jafari Azad; Amirmasoud Kazemzadeh Houjaghan; Ghazal Behzad; Negin Abiri Jahromi; Shabnam Zahirian; Elham Bazmi; Zahra Khazaeipour
Volume 24, Issue 2 , 2022
Abstract
Background: The coronavirus disease 2019 (COVID-19) epidemic is a great challenge among healthcare workers, especially nurses, due to their more frequent and closer contact with patients.
Objectives: This study aimed to evaluate anxiety, depression, and their causes among nurses with COVID-19 infection ...
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Background: The coronavirus disease 2019 (COVID-19) epidemic is a great challenge among healthcare workers, especially nurses, due to their more frequent and closer contact with patients.
Objectives: This study aimed to evaluate anxiety, depression, and their causes among nurses with COVID-19 infection in different wards of a hospital.
Methods: This cross-sectional study was carried out between February 1st to October 30th, 2020, among all nurses with COVID-19 infection in different wards of Imam Khomeini Hospital (university hospital), Tehran, Iran. The nurses were contacted by phone, and data were collected using a self-administered, valid, structured questionnaire consisting of sociodemographic characteristics and clinical symptoms. Psychological complications, including anxiety and depression levels, were assessed and their association with other sociodemographic variables was also evaluated.
Results: A total of 158 nurses were entered into the study, out of which 112 (70.2%) cases were females. Among all participants, 72.8% and 42.4% of the subjects reported anxiety and depression, respectively. The frequency of moderate to severe anxiety was significantly greater in women than in men (P<0.001). The infected nurses who worked in low-risk departments experienced a greater proportion of moderate to severe depression (P=0.004). In addition, the most prevalent reason for anxiety and depression was found to be the fear of infecting family members.
Conclusion: Nurses bear a significant psychological burden during the COVID-19 pandemic, markedly when they get infected and experience clinical symptoms. Therefore, the government and other staff should provide some facilities and supportive administrative work for reducing anxiety and depression and improving nurses' psychological health.
Research articles
Fatih Dal; U?ur Topal; Erdogan Mutevelli Sozuer; Muhammet Akyuz; Tutkun Talih; Hizir Yakup Akyildiz
Volume 24, Issue 2 , 2022
Abstract
Objective: In this five-year study, we aimed at investigating the factors related to strangulation and mortality in patients who underwent urgent surgery to treat incarcerated abdominal wall hernias.Methods: Patients presenting to the emergency department with an incarcerated abdominal wall hernia (incisional, ...
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Objective: In this five-year study, we aimed at investigating the factors related to strangulation and mortality in patients who underwent urgent surgery to treat incarcerated abdominal wall hernias.Methods: Patients presenting to the emergency department with an incarcerated abdominal wall hernia (incisional, umbilical, femoral, or inguinal) between October 2015and October 2019 were included in the study. The presence of intraoperative ischemia and necrosis was defined as "strangulation." Depending on the presence or absence of strangulation in the incarcerated segment, patients were divided into two groups: Group 1 (nonstrangulated) and Group 2 (strangulated). Between the groups, length of time between incarceration and hospital admission, demographic and clinical data, and physical examination findings, Risk factors for strangulation and mortality were determined with univariate and multivariate analyses.Results: A total of 161 patients were enrolled in the study. Group 1 consisted of 119 patients and Group 2 consisted of 42 patients. In multivariate analysis, the prominent risk factors for strangulation were: high ASA score (p=0.008), acute abdomen findings with distension and elevated body temperature (p<0.001), delayed hospital admission (p<0.001), procalcitonin >0.5 ng/ml (p<0.001), D-Dimer > 500 µg/L (p<0.001), lactate > 2 mmol/L (p<0.001),and creatinine levels > 2 mg/dl (p<0.001). For mortality, the presence of strangulation (p<0.001), lactate levels > 2 mg/dl (p=0.004), and ASA scores > 3 (p =0.035) were the leading risk factors.Conclusion: The most significant risk factors for strangulation were delay of more than 48 hours, high procalcitonin, creatinine, lactate and D-Dimer levels while for mortality, strangulation, high lactate and ASA levels were significantly effective. Mortality rates may be lowered with an earlier diagnosis, more specifically, one made before the development of metabolic and radiologic impairment.
