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Sarrafzadegan N, Bagherikholenjani F, Shahidi S, Ghasemi G, Shirvani E, Rajati F, Najafi F, Ghaffari S, Khosravi A, Assareh A, Adel SMH, Kojuri J, Samiei N, Masoudkabir F, Farshidi H, Kermani-Alghoraishi M, Sadeghi M, Shafei D, Jorjani M, Siavash M, Khorvash F, Isfahani MN, Fatemi B, Davari M, Moradinia M, Hoseinkhani R, Hajhashemi V, Mohammadifard N, Mobarhan MG, Momeni A, Mortazavi M, Akbari M, Sattar F, Noohi F, Kheiri M, Tabatabaeilotfi M, Bakhshandeh S, Janjani P, Fakhri S, Abdi A. Development of the first Iranian clinical practice guidelines for the diagnosis, treatment, and secondary prevention of acute coronary syndrome. JOURNAL OF RESEARCH IN MEDICAL SCIENCES : THE OFFICIAL JOURNAL OF ISFAHAN UNIVERSITY OF MEDICAL SCIENCES 2024; 29:32. [PMID: 39239072 PMCID: PMC11376720 DOI: 10.4103/jrms.jrms_851_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/31/2023] [Revised: 02/20/2024] [Accepted: 03/04/2024] [Indexed: 09/07/2024]
Abstract
Background This article introduces the first national guidelines for the management including diagnosis, treatment, and secondary prevention of acute coronary syndrome (ACS) in Iran. Materials and Methods The members of the guideline development group (GDG) were specialists and experts in fields related to ACS and were affiliated with universities of medical sciences or scientific associations in the country. They carefully examined the evidence and clinical concerns related to ACS management and formulated 13 clinical questions that were sent to systematic review group who developed related evidence using Grade method. Finally the GDG developed the recommendations and suggestions of the guideline. Results The first three questions in the guideline focus on providing recommendations for handling a patient who experience chest pain at home, in a health house or center, during ambulance transportation, and upon arrival at the emergency department (ED) as well as the initial diagnostic measures in the ED. Subsequently, the recommendations related to the criteria for categorizing patients into low, intermediate and high-risk groups are presented. The guideline addressed primary treatment measures for ACS patients in hospitals with and without code 247 or having primary percutaneous coronary intervention (PCI) facilities, and the appropriate timing for PCI based on the risk assessment. In addition, the most efficacious antiplatelet medications for ACS patients in the ED as well as its optimal duration of treatment are presented. The guideline details the recommendations for therapeutic interventions in patients with ACS and acute heart failure, cardiogenic shock, myocardial infarction with nonobstructive coronary arteries (MINOCA), multivessel occlusion, as well as the indication for prescribing a combined use of anticoagulants and antiplatelet during hospitalization and upon discharge. Regarding secondary prevention, while emphasizing the referral of these patients to rehabilitation centers, other interventions that include pharmaceutical and nonpharmacological ones are addressed, In addition, necessary recommendations for enhancing lifestyle and posthospital discharge pharmaceutical treatments, including their duration, are provided. There are specific recommendations and suggestions for subgroups, such as patients aged over 75 years and individuals with heart failure, diabetes, and chronic kidney disease. Conclusion Developing guidelines for ACS diagnosis, treatment and secondary prevention according to the local context in Iran can improve the adherence of our health care providers, patients health, and policy makers plans.
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Affiliation(s)
- Nizal Sarrafzadegan
- Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
- Iranian Network of Cardiovascular Research, Tehran, Iran
| | - Fahimeh Bagherikholenjani
- Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Shahla Shahidi
- Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Golsa Ghasemi
- Isfahan Kidney Disease Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ehsan Shirvani
- Iranian Network of Cardiovascular Research, Tehran, Iran
- Interventional Cardiology Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Fatemeh Rajati
- Department of Health Education and Health Promotion, School of Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Farid Najafi
- Research Center for Environmental Determinants of Health, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Samad Ghaffari
- Iranian Network of Cardiovascular Research, Tehran, Iran
- Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Alireza Khosravi
- Iranian Network of Cardiovascular Research, Tehran, Iran
- Hypertension Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ahmadreza Assareh
- Iranian Network of Cardiovascular Research, Tehran, Iran
- Atherosclerosis Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Seyed Mohammad Hassan Adel
- Iranian Network of Cardiovascular Research, Tehran, Iran
- Department of Cardiology, Faculty of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Javad Kojuri
- Iranian Network of Cardiovascular Research, Tehran, Iran
- Department of Cardiovascular Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Niloufar Samiei
- Iranian Network of Cardiovascular Research, Tehran, Iran
- Heart Valve Disease Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Farzad Masoudkabir
- Iranian Network of Cardiovascular Research, Tehran, Iran
- Cardiac Primary Prevention Research Center, Cardiovascular Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Hossein Farshidi
- Iranian Network of Cardiovascular Research, Tehran, Iran
- Cardiovascular Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Mohammad Kermani-Alghoraishi
- Iranian Network of Cardiovascular Research, Tehran, Iran
- Interventional Cardiology Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Masoumeh Sadeghi
- Iranian Network of Cardiovascular Research, Tehran, Iran
- Cardiac Rehabilitation Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Davood Shafei
- Iranian Network of Cardiovascular Research, Tehran, Iran
- Heart Failure Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Masoumeh Jorjani
- Department of Pharmacology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mansour Siavash
- Isfahan Endocrine and Metabolism Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Fariborz Khorvash
- Isfahan Neurosciences Research Center, Alzahra Hospital, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mehdi Nasr Isfahani
- Department of Emergency Medicine, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Behzad Fatemi
- Department of Pharmacoeconomics and Pharmaceutical Administration, Pharmaceutical Management and Economic Research Center, School of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran
| | - Majid Davari
- Department of Pharmacoeconomics and Pharmaceutical Administration, Pharmaceutical Management and Economic Research Center, School of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran
| | - Mitra Moradinia
- Physician of Community Health Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ramesh Hoseinkhani
- Deputy of Public Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Valiollah Hajhashemi
- Department of Pharmacology and Toxicology, School of Pharmacy and Pharmaceutical Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Noushin Mohammadifard
- Pediatric Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Majid Ghayour Mobarhan
- Iranian UNESCO Center of Excellence for Human Nutrition, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Ali Momeni
- Department of Internal Medicine, School of Medical Science, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - Mojgan Mortazavi
- Isfahan Kidney Disease Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohammad Akbari
- Department of Mental Health Nursing, Nursing and Midwifery Care Research Center, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Fereshteh Sattar
- Cardiology Department, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
| | - Fereidoun Noohi
- Iranian Network of Cardiovascular Research, Tehran, Iran
- Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Maryam Kheiri
- Department of Health, Ministry of Health and Medical Education, Tehran, Iran
| | - Mosa Tabatabaeilotfi
- Department of Treatment, Development of Standard and Clinical Practice Guideline Group, Ministry of Health and Medical Education, Tehran, Iran
| | - Sanaz Bakhshandeh
- Department of Treatment, Development of Standard and Clinical Practice Guideline Group, Ministry of Health and Medical Education, Tehran, Iran
| | - Parisa Janjani
- Cardiovascular Research Center, Health Institute, Imam-Ali Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Sajad Fakhri
- Pharmaceutical Sciences Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Alireza Abdi
- Department of Emergency and Critical Care Nursing, Faculty of Nursing and Midwifery, Kermanshah University of Medical Sciences, Kermanshah, Iran
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Hashemiyazdi SH, Masoudifar M, Rahimi Z, Honarmand A, Aryafar M. Comparative study of the effect of two different doses of remifentanil on bleeding control in lumbar fusion surgery: A randomized clinical trial. Ann Med Surg (Lond) 2022; 82:104761. [PMID: 36268379 PMCID: PMC9577819 DOI: 10.1016/j.amsu.2022.104761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 09/12/2022] [Accepted: 09/19/2022] [Indexed: 11/30/2022] Open
Abstract
Objectives Spinal fusion surgery completely prevents movement or friction between the two vertebrae. Remifentanil, a selective drug agonist, suppresses and decreases the vasomotor system upon release of histamine. In this study, the efficacy of remifentanil infusion at doses of 0.1 and 0.3 μg/kg/min in the control of low blood pressure was compared. Methods In this randomized clinical trial, 110 candidates for selective spinal fusion surgery were entered and randomized into 2 groups. The first group received 0.1 μg/kg/min and in the second group 0.3 μg/kg/min remifentanil. The systolic and diastolic blood pressure, pulse rate, SPO2, and surgeon's satisfaction were measured and compared between groups. Results the systolic blood pressure was significantly lower in patients receiving 0.3 μg of remifentanil by the time 30, 45, 60, and 90 min during the surgeries (P < 0.05). No significant difference was observed in terms of PR (P = 0.19) and SPO2 (P = 0.41) between the two groups. We also observed significantly higher duration of surgeries (P = 0.002), duration of anesthesia (P = 0.009), significantly higher bleeding volume (P < 0.001), higher fluid intake (P = 0.01) and higher transfused blood (P = 0.01) in patients that received 0.1 μg remifentanil compared to other patients. Conclusion Here we showed that administration of 0.3 μg/kg/min remifentanil was associated with significantly lower systolic blood pressure during the surgeries. On the other hand, patients that received 0.1 μg/kg/min remifentanil had significantly higher duration of surgeries, duration of anesthesia, significantly higher bleeding volume, higher fluid intake, and also higher transfused blood. Spinal fusion surgery completely prevents movement or friction between the two vertebrae. Remifentanil, a selective drug agonist, suppresses and decreases the vasomotor system. 0.3 μg/kg/min remifentanil was associated with significantly lower systolic blood pressure. Patients that received 0.1 μg/kg/min remifentanil had significantly higher duration of surgeries.
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Affiliation(s)
- Seyedeh Hamideh Hashemiyazdi
- Department of Anesthesiology, School of Medicine, Anesthesiology and Critical Care Research Center, Al-Zahra Hospital, Isfahan University of Medical Sciences, Isfahan, Iran
- Department of Anesthesiology, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran
| | - Mehrdad Masoudifar
- Department of Anesthesiology, School of Medicine, Anesthesiology and Critical Care Research Center, Al-Zahra Hospital, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Zahra Rahimi
- Department of Anesthesiology, School of Medicine, Al-Zahra Hospital, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Azim Honarmand
- Department of Anesthesiology, School of Medicine, Anesthesiology and Critical Care Research Center, Al-Zahra Hospital, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohamad Aryafar
- Department of Anesthesiology, Faculty of Medicine, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
- Corresponding author. Islamic Azad University, Tehran, Iran.
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Zahedi M, Shirmohammadi M. The effect of cardiac rehabilitation on left and right ventricular function in post primary PCI patients. Ann Med Surg (Lond) 2022; 79:104093. [PMID: 35860115 PMCID: PMC9289501 DOI: 10.1016/j.amsu.2022.104093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 06/24/2022] [Accepted: 06/24/2022] [Indexed: 11/24/2022] Open
Abstract
Objective Acute myocardial infarction is the most severe manifestation of coronary artery disease. Cardiac rehabilitation programs following percutaneous coronary intervention (PCI) assist patients to get back to their daily routine and can improve their cardiovascular health. The aim of this study was to evaluate the effect of cardiac rehabilitation in patients after primary PCI on the left and right ventricular function. Methods In this cross-sectional study, patient who underwent primary PCI following myocardial infarction were included. Month after the PCI procedure, 5 sessions of cardiac rehabilitation program were performed based on the patient's symptoms and according to the diagnosis by cardiologist. The duration of each rehabilitation session started from 20 min in the first session and reached 60 min in the last session. Exercises included walking on a treadmill and pedaling a stationary bike with limbs. Ventricular function was assessed after primary PCI and after the rehabilitation program. Patients were followed up by telephone after one year of the rehabilitation program. Results 30 patients were enrolled in the study, 23 of whom were male (76.7%). Right ventricular function did not change after the cardiac rehabilitation program compared to before (p = 1.00). Left ventricular function significantly increased after rehabilitation (p = 0.003). Increased left ventricular function was significant only in males (p < 0.001). Cardiac rehabilitation program in people over 60 years did not change left ventricular function (p < 0.05). One year after the cardiac rehabilitation program, 3 patients (10%) died. Conclusion The findings of our study showed that the implementation of an exercise-based cardiac rehabilitation program improves left ventricular function in patients with myocardial infarction after primary PCI but does not affect right ventricular function. The findings also showed that cardiac rehabilitation program may be associated with the gender and the age of the patients. Acute myocardial infarction is the most severe manifestation of coronary artery disease. CRP following PCI assist patients to get back to their daily routine and can improve their cardiovascular health. The implementation of an exercise-based cardiac rehabilitation program improves left ventricular function. In patients with myocardial infarction after primary PCI but does not affect right ventricular function. The findings also showed that cardiac rehabilitation program may be associated with the gender and the age of the patients.
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Affiliation(s)
- Mahdi Zahedi
- Ischemic Disorders Research Center, Golestan University of Medical Sciences, Gorgan, Iran
- Corresponding author. Interventional Cardiology, Golestan University of Medical Sciences, Gorgan, Iran.
| | - Mehrdad Shirmohammadi
- Student Research Committee, School of Medicine, Golestan University of Medical Sciences, Gorgan, Iran
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Comparison of preoperative and one-month postoperative serum cholesterol after cholecystectomy. Ann Med Surg (Lond) 2022; 79:104016. [PMID: 35860151 PMCID: PMC9289384 DOI: 10.1016/j.amsu.2022.104016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 05/27/2022] [Accepted: 06/02/2022] [Indexed: 11/23/2022] Open
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Rafiei H, Bahrami N, Meisami AH, Azadifar H, Tabrizi S. The effect of epinephrine and methylprednisolone on cardiac arrest patients. Ann Med Surg (Lond) 2022; 78:103832. [PMID: 35734658 PMCID: PMC9206913 DOI: 10.1016/j.amsu.2022.103832] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2022] [Revised: 05/16/2022] [Accepted: 05/17/2022] [Indexed: 11/18/2022] Open
Abstract
Background Methods Results Conclusion CPR involves organized procedures performed on patients with cardiac arrest. CPR method and techniques can determine neurological outcomes of the patients. Glucocorticoid, methylprednisolone does not reduce the risk of neurological complications.
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Affiliation(s)
- Hooman Rafiei
- Department of Emergency Medicine, Faculty of Medicine, Kermanshah University of Medical Science, Kermanshah, Iran
- Clinical Research Development Center, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Nasrin Bahrami
- Student of Research Committee, Kermanshah University of Medical Science, Kermanshah, Iran
| | - Amir Hossein Meisami
- Department of Emergency Medicine, Faculty of Medicine, Kermanshah University of Medical Science, Kermanshah, Iran
| | - Haniyeh Azadifar
- Clinical Research Development Center, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Shahrouz Tabrizi
- Department of Emergency Medicine, Faculty of Medicine, Kermanshah University of Medical Science, Kermanshah, Iran
- Corresponding author.
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Frequency of recurrence of peripheral artery disease among angioplasty and stenting patients. Ann Med Surg (Lond) 2021; 72:103146. [PMID: 34925825 PMCID: PMC8649217 DOI: 10.1016/j.amsu.2021.103146] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 12/01/2021] [Accepted: 12/01/2021] [Indexed: 12/25/2022] Open
Abstract
Background Peripheral artery disease (PAD) is a cardiovascular disease that is characterized by obstruction of peripheral artery. It is associated with comorbidities, reduced quality of life and mortality. The aim of this study was to determine the frequency of recurrence of PAD among patients who underwent angioplasty or stenting and associated risk factors. Methods In this retrospective study, all patients referred to the cardiovascular center of (XXX) with the diagnosis of lower extremity PAD were included. Patients’ demographic information, age, gender, smoking status, history of diabetes, history of hypertension, dyslipidemia, number of vessels, type of stent, recurrence of the disease, and size of the lesion were obtained from the hospital database. Endovascular revascularization therapy was either performed by angioplasty or stenting method. The data were analyzed by SPSS v21. Results Of 88 patients included in this study, 12.5% were reported with restenosis. Gender, age, size of the lesion, the status of smoking, history of hypertension, and dyslipidemia were not significantly associated with the recurrence of stenosis, p > 0.05. There was a significant relationship between the vessels involved and the type of revascularization method and the recurrence of the PAD. Conclusion Endovascular revascularization technique and type of vessel involved in PAD are significant factors contributing to restenosis in our population of study. However, further studies with a greater sample size are required in this area. Peripheral artery disease is a cardiovascular disease with obstruction of peripheral artery. It is associated with comorbidities, reduced quality of life and even mortality. Endovascular revascularization technique in PAD are significant factor in our study. However, further studies with greater sample size are required in this area.
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Ahmadinejad M, Ahmadinejad I, Maghsoudi LH, Soltanian A, Safari M. Complications in Patients with Cardiac Penetrating Trauma. Cardiovasc Hematol Disord Drug Targets 2021; 21:212-216. [PMID: 34906065 DOI: 10.2174/1871529x21666211214155349] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Revised: 11/15/2021] [Accepted: 11/26/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND Cardiac penetrating trauma is a medical emergency that mostly affects young people. Based on the type of injury and associated complications, it can present as a surgical challenge and can lead to mortality. OBJECTIVE The aim of this study is to evaluate the complications of penetrating heart trauma among patients referred to Shahid Madani Hospital. METHODS In this retrospective descriptive study, the data of penetrating cardiac trauma patients referred to Shahid Madani hospital, Karaj, Tehran, from 2016-2019, were investigated. Information, including age, sex, cause of trauma, traumatized area and complications, was extracted and recorded in a data collection form. The data were evaluated statistically using SPSS v18. RESULTS A total of 44 patients were included in the study, where the mean age of the patients was 25 years. 73.3% of these patients were men and 26.7% were women. Knife stab wounds were the most prevalent cause of the trauma, present in 93.3% of patients. 73.3% of the patients had cardiac tamponade and 20% had a pneumothorax. The right ventricle was the most common site of the injury in 46.7% of the patients. A mortality rate of 3.4% was reported in this study. CONCLUSION The results of this study showed that the highest penetrating heart rate trauma occurred among young people, and the most common cause of the trauma was a knife stab. The most common area of the injury was the right ventricular, and cardiac tamponade was the most common complication.
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Affiliation(s)
- Mojtaba Ahmadinejad
- Department of Surgery, School of Medicine, Shahid Madani Hospital, Alborz University of Medical Sciences, Karaj. Iran
| | | | - Leila Haji Maghsoudi
- Department of Surgery, School of Medicine, Shahid Madani Hospital, Alborz University of Medical Sciences, Karaj. Iran
| | - Ali Soltanian
- Department of Surgery, School of Medicine, Alborz University of Medical Sciences, Karaj. Iran
| | - Mehdi Safari
- Student Research Committee, Alborz University of Medical Sciences, Karaj. Iran
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Mohammadzadeh N, Rezayi S, Tanhapour M, Saeedi S. Telecardiology interventions for patients with cardiovascular Disease: A systematic review on characteristics and effects. Int J Med Inform 2021; 158:104663. [PMID: 34922178 DOI: 10.1016/j.ijmedinf.2021.104663] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 12/01/2021] [Accepted: 12/07/2021] [Indexed: 11/18/2022]
Abstract
INTRODUCTION The prevalence and mortality of cardiovascular diseases are high worldwide. Telecardiology can be used to diagnose and treat these diseases. This paper aimed to review the effectiveness (positive and negative) of implemented telecardiology services in terms of clinical, economic, and patient-reported aspects. METHODS A comprehensive search was conducted in Medline (through PubMed), Scopus, ISI web of science, and IEEE Xplore databases from inception to April 7, 2021. the studies that examined the effectiveness of telecardiology interventions were included. RESULTS Fifty studies were included in this systematic review. Most investigations (22%) were conducted in the US. In 22% of studies, telecardiology intervention was used for patients with heart failure. Telecardiology has been used in most studies for tele-monitoring (n = 21, 42%) and tele-consultation (n = 17, 34%) and in 29 studies (58%), was applied for ECG transmission. The highest rate of effects reported by studies was clinical. Thirty-five studies (70%) reported the clinical effects; twenty-one studies reported the positive effects for the economic category, and fifteen studies reported the positive effect for patient-reported class. The most positive clinical effects of telecardiology were early diagnosis, early treatment, and mortality reduction. The most positive effect of the economic class was the reduction of health care costs. The most effects of the patient-reported category were improving the patient's quality of life and patient satisfaction. CONCLUSION Telecardiology can help early diagnosis and treatment of cardiovascular diseases. It also has great potential in reducing health care costs and increasing quality of life and patient satisfaction.
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Affiliation(s)
- Niloofar Mohammadzadeh
- Department of Health Information Management, School of Allied Medical Sciences, Tehran University of Medical Sciences, Tehran, Iran
| | - Sorayya Rezayi
- Department of Health Information Management, School of Allied Medical Sciences, Tehran University of Medical Sciences, Tehran, Iran
| | - Mozhgan Tanhapour
- Department of Health Information Management, School of Allied Medical Sciences, Tehran University of Medical Sciences, Tehran, Iran
| | - Soheila Saeedi
- Clinical Research Development Unit of Farshchian Heart Center, Hamadan University of Medical Sciences, Hamadan, Iran; Health Information Management and Medical Informatics Department, School of Allied Medical Sciences, Tehran University of Medical Sciences, Tehran, Iran.
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Marzban-Rad S, Bozorgmehr R, Sattari P, Azimi G, Azimi A. Radical extrapleural pneumonectomy with bronchial fistula by pulmonary function test evaluation technique. Ann Med Surg (Lond) 2021; 72:103071. [PMID: 34840777 PMCID: PMC8605380 DOI: 10.1016/j.amsu.2021.103071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 11/14/2021] [Accepted: 11/15/2021] [Indexed: 10/24/2022] Open
Abstract
INTRODUCTION and importance: Pulmonary Function Tests (PFTS) is an important tool in the assessment of pulmonary pathologies and preoperative evaluation. Case presentation: A 54-year-old man with history of massive pleurisy in the left thorax, treated by placing chest tube and drainage of bloody effusion, was readmitted for epithelioid mesothelioma. He was then presented with pneumothorax due by a refractory bronchial fistula while having a plural catheter. Based on the consultation, the whole-body bone scan was conducted, and findings demonstrated epithelioid mesothelioma (stage 1) with the refractory fistula for which the patient was candidate for thoracic surgery. Decreased lung capacity was seen by Pulmonary Function Testing - PFTS. CLINICAL DISCUSSION The novel PFTS Evaluation Technique was designed to measure the true pulmonary capacities in order to evaluate the pulmonary post-operative tolerance. In this technique the chest tube was placed for 4 weeks until the patient reaches mediastinal fixation then the measurements by PFTS were carried out in two steps. First, using an open chest tube and second, using a clamped chest tube. In both steps, the pulmonary capacities were measured and provided to the pulmonologist for consultation. CONCLUSION In this case, after acquiring the approval of the specialist depended on PFTS after PFTS Evaluation Technique, the radical extra pleural pneumonectomy surgery was conducted, and the patient was discharged with a good general appearance and treated fistula.
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Affiliation(s)
- Saeid Marzban-Rad
- Department of Thoracic Surgery, Imam-Reza Hospital, Aja University of Medical Sciences, Tehran, Iran
| | - Rama Bozorgmehr
- Clinical Research Development Unit, Shohadaye Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Parastesh Sattari
- General Practitioner, Institute of Health Education and Research, Chamran Hospital, Tehran, Iran
| | - Ghasem Azimi
- Department of Internal Medicine, School of Medicine, Shahed University, Tehran, Iran
| | - Ali Azimi
- Student of Research Committee, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
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Shakarami A. An idiopathic case of precordial deep T-wave inversion. Ann Med Surg (Lond) 2021; 71:102959. [PMID: 34703593 PMCID: PMC8521169 DOI: 10.1016/j.amsu.2021.102959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 10/14/2021] [Accepted: 10/14/2021] [Indexed: 12/07/2022] Open
Abstract
Introduction and importance One percent of the patients referred to cardiac intensive care unit (CICU) are presented with T-wave inversion. Case presentation We present a case of 78-year-old woman with chest pain and dyspnea. ECG showed precordial deep T-wave inversion. Clinical discussion Cardiomyopathies, ischemia and other pathologies were ruled out. Conclusion It is likely to be a first reported case of idiopathic deep T-wave inversion seen in the family without any cardiac or non-cardiac etiology. T-wave inversion is commonly presented in electrocardiogram (ECG) of infants. Precordial lead T-wave inversion is seen in infants and can be seen in childhood period as well. Familial clustering of this type of ECG was attractive. Genetic analysis of these findings can give more meaningful conclusions.
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Affiliation(s)
- Amir Shakarami
- Department of Cardiology, Faculty of Medicine, Lorestan University of Medical Sciences, Khorramabad, Iran
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Nezami A, Heidari G, Tarhani F, Oliaee F. Frequency of Cardiac Arrhythmias in Children with Cardiological Consulting and Containing Electrocardiogram. Cardiovasc Hematol Disord Drug Targets 2021; 21:141-146. [PMID: 34521334 DOI: 10.2174/1871529x21666210914113115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Revised: 04/08/2021] [Accepted: 05/24/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND Heart diseases are the leading causes of mortality and congenital heart disease (CHD) is the most common birth defect reported worldwide. OBJECTIVE The aim of this study was to evaluate the incidence of arrhythmias and CHD and the association between the two, among infants and children reported to our center. METHODS This cross-sectional study included infants and children who were referred to Shahid Madani Hospital, Khorramabad. Electrocardiogram (ECG) was performed in these children to determine the type of arrhythmia and records were used to obtain demographic data and the data regarding CHD. RESULTS Of 200 children enrolled in the study, 10 children had arrhythmias, 12 had tachycardia, 5 had bradycardia, and 31 had congenital disease. Among children with arrhythmias, 1 had atrial fibrillation, 4 patients had paroxysmal supraventricular tachycardia, 1 person had right bundle branch block, 1 had ventricular tachycardia, 2 had premature ventricular contractions and 1 had junctional ectopic tachycardia. Of the 31 children with CHD, 9 patients were presented with small ventricular septal defect, 4 children had patent foramen ovale, 2 had pulmonary stenosis and 1 of the children had tetralogy of fallout, arterial and ventricular septal defects and transposition of greater arteries, respectively. CONCLUSION We reported a positive correlation between the arrhythmias and CHD. A larger number of studies collecting focusing on different age groups are therefore required to verify our findings.
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Affiliation(s)
- Alireza Nezami
- Department of Pediatrics, Faculty of Medicine, Lorestan University of Medical Sciences, Khorramabad. Iran
| | - Ghobad Heidari
- Department of Pediatrics, Faculty of Medicine, Lorestan University of Medical Sciences, Khorramabad. Iran
| | - Fariba Tarhani
- Department of Pediatrics, Faculty of Medicine, Lorestan University of Medical Sciences, Khorramabad. Iran
| | - Fatemeh Oliaee
- Student of Research Committee, Lorestan University of Medical Sciences, Khorramabad. Iran
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Ahmadinejad M, Pak H, Soltanian A, Pouryaghobi SM, Mohammadzadeh S, Ahmadi A, Ahmadinejad I. A retrospective study on the cardiac assessment of isolated sternal fracture patients based on radiographic and clinical outcomes. Ann Med Surg (Lond) 2021; 69:102762. [PMID: 34471533 PMCID: PMC8387903 DOI: 10.1016/j.amsu.2021.102762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Revised: 08/17/2021] [Accepted: 08/22/2021] [Indexed: 12/04/2022] Open
Abstract
OBJECTIVE Sternal fracture may be associated with major and serious injuries. In this study, the complications associated with isolated sternal fracture in trauma patients are evaluated based on radiographic and cardiac findings. METHODS This retrospective study was performed on patients with isolated sternal fractures admitted to the emergency department of (XXX) Madani Educational-Medical. Data regarding demographic information, mechanism of trauma, length of hospitalization, electrocardiography (ECG), cardiac enzyme, and chest radiography were recorded in the questionnaire for each patient. RESULTS The mean age of patients 41.2 + 11.04 years and 63.9% were male. The most common cause of the trauma was car accidents in 41% (25 cases). The mean duration of hospitalization was 1.54 ± 0.90 days. The mechanism of trauma was not associated with x-ray and computed tomography findings, p = 0.53 and p = 0.86, respectively. ECG findings were significantly related to x-ray and computed tomography outcomes, p < 0.001, respectively. CONCLUSION Patients with isolated sternal fracture with displacement >0.5 cm and hematoma are likely to require cardiac consultation.
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Affiliation(s)
- Mojtaba Ahmadinejad
- Department of Surgery, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran
| | - Haleh Pak
- Department of Surgery, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran
| | - Ali Soltanian
- Department of Surgery, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran
| | - Seyyed Mohsen Pouryaghobi
- Department of Anesthesiology, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran
| | - Sanaz Mohammadzadeh
- Student Research Committee, Alborz University of Medical Sciences, Karaj, Iran
| | - Abtin Ahmadi
- Student Research Committee, Alborz University of Medical Sciences, Karaj, Iran
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Zamanabadi MN, Alizadeh R, Gholami F, Seyed mehdi SA, Aryafar M. Effect of caffeine on postoperative bowel movement and defecation after cesarean section. Ann Med Surg (Lond) 2021; 68:102674. [PMID: 34401138 PMCID: PMC8358636 DOI: 10.1016/j.amsu.2021.102674] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 07/30/2021] [Accepted: 08/03/2021] [Indexed: 11/29/2022] Open
Abstract
INTRODUCTION and Importance: Inadequate bowel movement after cesarean section (C-section) can delay the intake of solid diet. Coffee is reported to have beneficial effects on bowel motility after the surgery. This study is designed to evaluate the effects of coffee on bowel movement and defecation following C-section. METHODS In this randomized clinical trial study, women undergoing elective C-section at the hospital of (XXX) during 2019-2020 were included. Following the surgery, the patients were divided in case (coffee) and control (water) group. At three different interval after the surgery, 111 ml of coffee or water was given to these patients. After the intervention, time of bowel movement, first defecation, body mass index (BMI), age, gestational age, parity and gravidity were recorded and evaluated between the two groups. RESULTS Of total 36 patients (18 in study and control group, respectively), the mean age, gravidity, parity, BMI and gestational age was not significantly different, p-value<0.05. The mean onset of bowel movements in case group was 14.56 h and control group was 16.83 h and the first defecation after cesarean section in case and control group was 27.78 and 31.67 h, respectively. The two groups were significantly different in both the terms, p-value = 0.042 and p-value = 0.002, respectively. CONCLUSION The postoperative bowel movement and defecation time is shorter with the intake of coffee among patients undergoing C-section.
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Affiliation(s)
- Mahnaz Narimani Zamanabadi
- Department of Anesthesiology, Faculty of Medicine, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
| | - Reza Alizadeh
- Department of Anesthesiology and Intensive Care, School of Medicine, AJA University of Medical Sciences, Tehran, Iran
| | - Farshid Gholami
- Department of Anesthesiology, Faculty of Medicine, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
| | - Seyed Ahmad Seyed mehdi
- Department of Anesthesiology, Faculty of Medicine, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
| | - Mohamad Aryafar
- Department of Anesthesiology, Faculty of Medicine, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
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Farazmehr K, Aryafar M, Gholami F, Dehghanmanshadi G, Hosseini SS. A prospective study on the incidence of sore throat after use of laryngeal mask airway during general anesthesia. Ann Med Surg (Lond) 2021; 68:102595. [PMID: 34401120 PMCID: PMC8353405 DOI: 10.1016/j.amsu.2021.102595] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2021] [Revised: 07/16/2021] [Accepted: 07/25/2021] [Indexed: 01/13/2023] Open
Abstract
Background Laryngeal mask airway (LMA) is a useful alternative to intubation of the trachea to maintain the airways. The aim of this study was to evaluate the incidence of sore throat after LMA during general anesthesia in short-duration elective surgery. Method In this prospective study, 76 patients undergoing surgery with general anesthesia in (XXX) during 2018 and 2019 were selected and their demographic information were entered into the data collection form. Laryngeal mask airway was used in the subjects for airway maintenance during the surgery. The incidence of sore throat at postoperative 0, 6, 12 h was measured using Visual Analogues Scale (VAS) as primary outcome and it was then compared with demographic parameters as secondary outcomes. Result The mean age of the patient was 45.48 ± 14.89 years and 46 (60.5 %) of the patients were women. The mean BMI was 24.02 ± 3.05 kg/m2. The average duration of surgery was 56.9 ± 15.9 min. The incidence of sore throat immediately after the surgery and at 6 and 12 postoperative hours was 26.3 %, 23.7 %, and 19.7 %, respectively. The incidence of sore throat after the use of LMA was not significantly correlated with age, sex, and BMI (P > 0.05) Conclusions The findings of our study showed that pain due to sore throat following laryngeal mask airway was reported to be mild in our study. The postoperative sore throat may not associated with demographic variables. Laryngeal mask airway is a useful alternative to intubation of the trachea to maintain the airways. Tracheal intubation is one of the invasive procedures used in patients undergoing surgery. The pain due to sore throat was reported to be mild in our study. Postoperative sore throat was not associated with demographic variables.
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Affiliation(s)
- Kourosh Farazmehr
- Department of Anaesthiology, Faculty of Medicine, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
| | - Mohamad Aryafar
- Department of Anaesthiology, Faculty of Medicine, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
| | - Farshid Gholami
- Department of Anaesthiology, Faculty of Medicine, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
| | - Giti Dehghanmanshadi
- Department of Anaesthiology, Faculty of Medicine, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
| | - Seyed Sepideh Hosseini
- Student of Research Committee, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
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Rezaei B, Ramazani E, Amiri R, Sanaei Z. A cross-sectional study on the prevalence of electrolyte abnormalities in multiple trauma patients in Hamedan, Iran. Health Sci Rep 2021; 4:e239. [PMID: 33732893 PMCID: PMC7944545 DOI: 10.1002/hsr2.239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 12/17/2020] [Accepted: 12/30/2020] [Indexed: 11/09/2022] Open
Abstract
INTRODUCTION Evaluation of electrolyte status and homeostasis is one of the most important components of evaluation and treatment of critically ill patients, especially those with multiple trauma. Electrolyte imbalance can be associated with a bad prognosis and the need of specialized consultancy. AIM The aim of this study was to evaluate and determine the electrolyte status of patients with multiple trauma and evaluate the relationship of electrolyte disorders with patient outcome. METHODS In this cross-sectional study, 370 patients who were referred to the emergency department of Besat Hospital in Hamadan, Iran with multiple trauma were studied. Demographic parameters clinical characteristics such as blood pressure, heart rate, respiratory rate, consciousness score and body temperature, paraclinical characteristics including radiographic status, ultrasound, and electrocardiography and serum levels of sodium, potassium, creatinine, hemoglobin, hematocrit, and BUN and urine analysis was performed. Data regarding the discharge from emergency department or referral to other units were also complete in a questionnaire for each patient. Statistical analyses were performed using SPSSv24. RESULTS Three hundred seventy patients with multiple trauma were studied where 73% of patients were men and 27% were women. One hundred ninety-six patients were discharged from the emergency department, and 174 patients were referred to other units of the hospital. The most common electrolyte abnormalities were hypotension (62.7%), hypernatremia (9.5%), hypokalemia (6.8%), and hypercreatinine (4.6%). The results of independent t-test showed that heart rate and potassium level were significantly higher in patients referred to other units than in patients discharged from the emergency department and respiratory rate and hematocrit were significantly lower in patients referred to other units. CONCLUSION Hypotension, hypernatremia, hypokalemia, hypercreatinine, and abnormal urine analysis were more frequent in patients referred to other units than in patients discharged from the emergency department. These variables can be considered in predicting patient status for referral to other units and delayed hospital discharge.
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Affiliation(s)
- Bareza Rezaei
- Department of Emergency, Faculty of Medicine, Taleghani HospitalKermanshah University of Medical SciencesKermanshahIran
- Clinical Research Development Center of TaleghaniKermanshah University of Medical SciencesKermanshahIran
| | - Einaz Ramazani
- Department of Emergency, Besat HospitalHamedan University of Medical SciencesHamedanIran
| | - Rahimpour Amiri
- Department of Pediatrics, Faculty of Medicine, Besat HospitalHamedan University of Medical SciencesHamedanIran
| | - Zahra Sanaei
- Department of Community Medicine, Education Development OfficeHamedan University of Medical SciencesHamedanIran
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Azadbakht M, Emadi-jamali SM, Azadbakht S. Hypocalcemia following total and subtotal thyroidectomy and associated factors. Ann Med Surg (Lond) 2021; 66:102417. [PMID: 34136209 PMCID: PMC8178078 DOI: 10.1016/j.amsu.2021.102417] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 05/15/2021] [Accepted: 05/16/2021] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Thyroidectomy is one of the common endocrinological surgeries for the treatment of thyroid disorders. Hypocalcemia is the potential complication after thyroidectomy, where is persistency can lead to serious systemic effects. The aim of this study is to evaluate the incidence of hypocalcemia in thyroidectomy patients. METHODS In this cross-sectional study, patients referred to (XXX) for thyroidectomy from 2019 to 2020 were enrolled. Preoperative serum calcium and postoperative 24- and 48-h calcium levels were evaluated in these patients. Demographic data (sex and gender), calcium levels, type of thyroidectomy and duration of surgery was recorded for all the patients. SPSS v22 was used for statistical analysis. P < 0.05 was considered as statistically significant. RESULTS Of 143 patients included in the study, the mean age was 49.7 ± 10.9 years and 61.5% were females and 38.5% were males. 49% patients had hypocalcemia in the first 24 hours after surgery and 63.6% following 48 hours of the surgery. The difference in calcium levels at three intervals were statistically significant, p = 0.001. The incidence of hypocalcemia was significantly more in women at 48 postoperative hours, p = 0.025. The age and duration of surgery was not significantly correlated with hypocalcemia, p > 0.05, whereas, patients who underwent total thyroidectomy had greater incidence of hypocalcemia 24 hours after the surgery, p = 0.021. CONCLUSIONS The incidence of hypocalcemia is greater in total thyroidectomy and female patients. Our study did not report significant correlation between duration of the surgery and age of the patients.
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Affiliation(s)
- Morteza Azadbakht
- Department of Surgery, Faculty of Medicine, Lorestan University of Medical Sciences, Khorramabad, Iran
| | | | - Saleh Azadbakht
- Department of Internal Medicine, School of Medicine, Lorestan University of Medical Sciences, Khorramabad, Iran
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Kiabi FH, Emadi SA, Shafizad M, Jelodar AG, Deylami H. The effect of preoperative sublingual buprenorphine on postoperative pain after lumbar discectomy: A randomized controlled trial. Ann Med Surg (Lond) 2021; 65:102347. [PMID: 34026096 PMCID: PMC8121872 DOI: 10.1016/j.amsu.2021.102347] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 04/19/2021] [Accepted: 04/25/2021] [Indexed: 12/20/2022] Open
Abstract
Background Lumbar discectomy is one of the most common surgical procedures performed to manage pain caused by the protrusion of an intervertebral disc. Postoperative pain management can be challenging and might lead to increased intake of opioids. Objective: The aim of this study was to determine the effect of preoperative sublingual buprenorphine on severity of pain after lumbar disc surgery and postoperative intake of morphine. Methods This Randomized clinical trial study was performed on 78 patients who were selected for lumbar discectomy surgery. Patients were randomly divided into two groups of 39 patients, each. Patients in the buprenorphine and placebo group received 2 mg buprenorphine sublingual, and placebo 1 h before surgery. Severity of pain, nausea, vomiting and pruritus and intake of opioids in the two groups were evaluated and recorded 1, 6, 12 and 24 h after surgery. Data were analyzed using SPSSv21. Results There was a significant difference in pain score in buprenorphine group at 1, 6, 12, and compared with placebo (P < 0.005). In the control group, the use of analgesics was more than the buprenorphine group. In the first hours after surgery (1–6 h), the incidence of nausea in the buprenorphine group was significantly lower than of the control group (P < 0.05). However, at 12 and 24 h, this difference was not observed, p > 0.05. There was no significant difference in incidence of side effects (nausea, vomiting, pruritus) in the two groups (P > 0.05). Conclusion Sublingual buprenorphine in postoperative pain management is an effective and low dose drug. Due to its simpler administration, it is recommended to relief postoperative pain after lumbar disc surgery. Lumbar discectomy is one of the most common surgical procedures performed to manage pain. Postoperative pain management can be challenging and might lead to increased intake of opioids. Sublingual buprenorphine in postoperative pain management is an effective and low dose drug. It is recommended to relief postoperative pain after lumbar disc surgery.
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Affiliation(s)
- Farshad Hassanzadeh Kiabi
- Department of Anesthesiology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Seyed Abdollah Emadi
- Department of Anesthesiology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Misagh Shafizad
- Department of Neurosurgery, School of Medicine, Orthopedic Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | | | - Hojat Deylami
- Student of Research Committee, Mazandaran University of Medical Sciences, Sari, Iran
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Shahmoradi MK, Zarei F, Beiranvand M, Hosseinnia Z. A retrospective descriptive study based on etiology of appendicitis among patients undergoing appendectomy. INTERNATIONAL JOURNAL OF SURGERY OPEN 2021. [DOI: 10.1016/j.ijso.2021.100326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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The impact of intercostal nerve block on the necessity of a second chest x-ray in patients with penetrating trauma: A randomised controlled trial. INTERNATIONAL JOURNAL OF SURGERY OPEN 2021. [DOI: 10.1016/j.ijso.2020.12.012] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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Vahabi S, Karimi A, Beiranvand S, Babaei S. Evaluating memory dysfunction after spinal anesthesia among patients undergoing elective surgery: Descriptive-analytical study. Ann Med Surg (Lond) 2021; 62:168-174. [PMID: 33520217 PMCID: PMC7820796 DOI: 10.1016/j.amsu.2021.01.034] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2020] [Revised: 01/11/2021] [Accepted: 01/11/2021] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Anesthesia has a number of side effects including cognitive impairment after the surgery. Postoperative cognitive impairment is commonly associated with general anesthesia. OBJECTIVE The aim of this study is to evaluate the effects of Marcaine (bupivacaine hydrochloride) in memory impairment among patients undergoing elective surgery. MATERIALS AND METHODS In this study descriptive-analytical study, patients undergoing elective lower extremity or lower abdomen surgery requiring spinal anesthesia were included. Following 24 h of the surgery, standard Wechsler questionnaire was used to assess memory of the patients. Other demographic and clinical parameters such as age, gender and blood pressure, pulse rate were also recorded. The obtained data was analyzed using SPSSv18. RESULTS In this study, 105 patients where 55 (52.4%) males and 50 (47.6%) females were studied. The mean age of the subjects was 35.73 ± 10.64 years. There was a significant difference between the mean of memory scores in terms of logical memory and overall memory (P < 0.001). There was a significant relationship between the mean scores of patients' rational memory and systolic blood pressure at admission (P = 0.030). There was a significant relationship between mean associative learning scores in patients and systolic blood pressure at admission (P = 0.046) and type of surgery (P = 0.013). Furthermore, overall memory scores were significantly associated with age (P = 0.041). CONCLUSION Based on the results of this study, it can be concluded that spinal anesthesia had a significant effect on some areas of memory. Further studies in this area can yield more reliable results.
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Affiliation(s)
- Sepideh Vahabi
- Department of Anesthesiology, Faculty of Medicine, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Arash Karimi
- Department of Anesthesiology, Faculty of Medicine, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Siavash Beiranvand
- Department of Anesthesiology, Faculty of Medicine, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Simin Babaei
- Department of Anesthesiology, Faculty of Medicine, Lorestan University of Medical Sciences, Khorramabad, Iran
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A cohort retrospective study on computed tomography scan among pediatric minor head trauma patients. INTERNATIONAL JOURNAL OF SURGERY OPEN 2021. [DOI: 10.1016/j.ijso.2021.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Kazem Shahmoradi M, Khoshdani Farahani P, Sharifian M. Evaluating outcomes of primary anastomosis versus Hartmann's procedure in sigmoid volvulus: A retrospective-cohort study. Ann Med Surg (Lond) 2021; 62:160-163. [PMID: 33520215 PMCID: PMC7820798 DOI: 10.1016/j.amsu.2021.01.019] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2020] [Revised: 01/10/2021] [Accepted: 01/10/2021] [Indexed: 02/07/2023] Open
Abstract
Background The aim of this study is to compare the short outcomes of two methods of sigmoid resection and primary anastomosis with sigmoid resection and end colostomy (Hartmann's procedure) for sigmoid volvulus. Methods This retrospective study included 102, of which 56 patients underwent end colostomy (Hartmann's procedure) and 46 patients underwent resection and primary anastomosis for sigmoid volvulus. The medical records of the patients were reviewed to evaluate the patients' characteristics, operative data, short-term postoperative outcomes and mortality. Results The mean age of patients in the groups of Hartmann's procedure and primary anastomosis were 68.23 ± 13.42 and 70.10 ± 12.71, respectively. From the 46 patients who had primary colorectal anastomosis, 2 patients (4.3%) suffered from anastomosis leakage, which was not significantly different. This study showed that anastomosis leakage, prolonged ileus, bleeding, surgical site infection and fascial dehiscence were not different between Hartmann's procedure and primary anastomosis, significantly, p < 0.05. Hospital stay in the Hartmann group was less than primary anastomosis group in the same admission, p = 0.04. The mortality rate was not statistically different among the two groups, p = 0.549. Conclusions Postoperative complications and mortality rate do not different among the two groups however, the duration of hospitalization was lesser in Hartmann's procedure group.
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Affiliation(s)
- Mohammad Kazem Shahmoradi
- Department of General Surgery, Faculty of Medicine, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Parham Khoshdani Farahani
- Department of General Surgery, Faculty of Medicine, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Masoud Sharifian
- Department of General Surgery, Faculty of Medicine, Lorestan University of Medical Sciences, Khorramabad, Iran
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Nezami A, Heidari G, Tarhani F, Kariminia M. Prevalence of Congenital Heart Disease among Children in Khorramabad (West of Iran). Cardiovasc Hematol Disord Drug Targets 2021; 21:61-65. [PMID: 33390151 DOI: 10.2174/1871529x20999201231205746] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 10/20/2020] [Accepted: 11/13/2020] [Indexed: 11/22/2022]
Abstract
AIMS Congenital heart disease is among the most common congenital anomalies in pediatrics. The aim of this study was to evaluate the prevalence of congenital heart disease in children in Khorramabad, Iran. METHODS This is a descriptive-cross sectional study where all the children diagnosed with congenital heart disease by echocardiography were enrolled to the Shahid Madani Hospital. Patient information was collected by means of a questionnaire. Of 1600 children who underwent cardiac counseling, 9.75% presented congenital heart disease. These were most prevalent among the children of 0-28 days of the age (14.7%) and least in children aged 1 month-1 year. According to this study, atrial (20.3%) and ventricular septal defect (10.5%) were the most common heart defects, respectively. Among signs and symptoms of cardiac disease, 49.1% of children had cyanosis, 89.7% with increased CT (cardiothoracic)-ratio, and 82.7% of had heart murmur. Congenital heart disease was more prevalent in male infants (58%) and 6.6% patients had heart failure and 1.4% had other congenital conditions, such as Down syndrome. RESULTS According to our findings, atrial and ventricular septal defects are the most common congenital heart anomalies, respectively, in pediatric patients in Khorramabad.
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Affiliation(s)
- Alireza Nezami
- Department of Paediatrics, Faculty of Medicine, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Ghobad Heidari
- Department of Paediatrics, Faculty of Medicine, Lorestan University of Medical Sciences, Khorramabad,, Iran
| | - Fariba Tarhani
- Department of Paediatrics, Faculty of Medicine, Lorestan University of Medical Sciences, Khorramabad,, Iran
| | - Masoumeh Kariminia
- Student of Research Committee, Lorestan University of Medical Sciences, Khorramabad, Iran
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Ahmadinejad M, Mohammadzadeh S, Shirzadi A, Soltanian A, Ahmadinejad I, Pouryaghobi SM. Trauma factors among adult and geriatric blunt trauma patients. INTERNATIONAL JOURNAL OF SURGERY OPEN 2021. [DOI: 10.1016/j.ijso.2020.12.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Jalali SM, Azadbakht M, Azadbakht S, Daniali S, Farokhi E. Prevalence of secondary hyperparathyroidism following bariatric surgery. INTERNATIONAL JOURNAL OF SURGERY OPEN 2020. [DOI: 10.1016/j.ijso.2020.11.022] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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26
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Aryafar M, Bozorgmehr R, Gholami F, Farazmehr K, Alizadeh R. A randomized double-blind clinical trial evaluating the effect of Elastic Stocking on Hemodynamic Changes and dose use of ephedrine for elective Cesarean surgery under spinal anesthesia. INTERNATIONAL JOURNAL OF SURGERY OPEN 2020. [DOI: 10.1016/j.ijso.2020.10.019] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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A cross-sectional study on the postoperative analgesic-associated side effects and clinical parameters following partial mastectomy. INTERNATIONAL JOURNAL OF SURGERY OPEN 2020. [DOI: 10.1016/j.ijso.2020.10.018] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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28
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Aryafar M, Bozorgmehr R, Alizadeh R, Gholami F. A cross-sectional study on monitoring depth of anesthesia using brain function index among elective laparotomy patients. INTERNATIONAL JOURNAL OF SURGERY OPEN 2020. [DOI: 10.1016/j.ijso.2020.11.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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