Shiraz E-Medical Journal Shiraz E-Medical Journal Shiraz E-Med J http://www.emedicalj.portal.tools 1735-1391 10.5812/semj. en jalali 2019 8 23 gregorian 2019 8 23 9 2
en Disseminated Intraabdominal Heat Injury in a Case of Laparoscopic Cholecystectomy Disseminated Intraabdominal Heat Injury in a Case of Laparoscopic Cholecystectomy case-report case-report

A 38 yr-old man was scheduled for laparoscopic cholecystectomy. General anesthesia was selected and induced. About 40 minutes after initiation of laparoscopic surgery a progressive tachycardia and hyperten- sion was noticed. We checked anesthetic machine, 02, inhalational anesthetics and appropriate position of tracheal tube. Then narcotic and muscle relaxant repeated but our efforts were ineffective. The operation ceased and when laparoscope was withdrawing it accidentally touched the anesthesiologist's hand. It was unexpectedly hot and heat injury supposed. The abdomen was opened immediately. Intraabdominal tem- perature was abnormally high and visceral organs were reddish and inflamed. After rapid irrigation of ab- domen with cold normal saline, tachycardia and hypertension regressed to normal situation and open cho- lecystectomy was down.

A 38 yr-old man was scheduled for laparoscopic cholecystectomy. General anesthesia was selected and induced. About 40 minutes after initiation of laparoscopic surgery a progressive tachycardia and hyperten- sion was noticed. We checked anesthetic machine, 02, inhalational anesthetics and appropriate position of tracheal tube. Then narcotic and muscle relaxant repeated but our efforts were ineffective. The operation ceased and when laparoscope was withdrawing it accidentally touched the anesthesiologist's hand. It was unexpectedly hot and heat injury supposed. The abdomen was opened immediately. Intraabdominal tem- perature was abnormally high and visceral organs were reddish and inflamed. After rapid irrigation of ab- domen with cold normal saline, tachycardia and hypertension regressed to normal situation and open cho- lecystectomy was down.

heat injury, laparoscopic cholecystectomy, electrocautery. heat injury, laparoscopic cholecystectomy, electrocautery. 113 117 http://www.emedicalj.portal.tools/index.php?page=article&article_id=20813 Mahin Jafari Javid Mahin Jafari Javid Assistant Professor, Department of Anesthesiology, Imam Hospital complex, Tehran University of Medical Sciences, Tehran, Iran; Department of Anesthesiology, Imam Khomeini Hospital, End of Keshavarz Boulvard, Tehran, Iran , +98-9121216524 Assistant Professor, Department of Anesthesiology, Imam Hospital complex, Tehran University of Medical Sciences, Tehran, Iran; Department of Anesthesiology, Imam Khomeini Hospital, End of Keshavarz Boulvard, Tehran, Iran , +98-9121216524
en Comparing the Effect of Stellate Ganglion Block and Gabapentin on the Post Mastectomy Pain Syndrome Comparing the Effect of Stellate Ganglion Block and Gabapentin on the Post Mastectomy Pain Syndrome research-article research-article Background

The reported incidence of post mastectomy pain syndrome following surgery for breast cancer varies considerably with reports from as low as 4-6% to as high as 100%. This pain can be severe enough to interfere with sleep and performance of daily activities. Post mastectomy pain syndrome is a neuropathic pain condition that can follow surgical treatment for breast cancer. The purpose of this study is to evaluate the effect of stellate ganglion block with gabapentin on post mastectomy pain.

Materials and Methods

Sixty patients referred from department of oncology and surgery to pain clinic were allocated to two groups. In group A stellate ganglion block was performed with 8ml bupivacaine 0.25%. In group B, patients were treated with gabapentin 900mg per day in three divided doses. Drug dose was increased if necessary until eight weeks. Pain score and quality of life were determined. Data were collected before treatment, 48 hours and every 15 days after treatment until three months.

Results

Pain scores at 48 hours after treating were higher in group B than group A and lower at one week, one month and three months after treatment which were statically significant. (P<0.001, 0.024, 0.047 and <0.001 respectively)

Conclusion

In our study gabapentin was used as an ideal treatment technique for chronic pain following breast surgery.

Background

The reported incidence of post mastectomy pain syndrome following surgery for breast cancer varies considerably with reports from as low as 4-6% to as high as 100%. This pain can be severe enough to interfere with sleep and performance of daily activities. Post mastectomy pain syndrome is a neuropathic pain condition that can follow surgical treatment for breast cancer. The purpose of this study is to evaluate the effect of stellate ganglion block with gabapentin on post mastectomy pain.

Materials and Methods

Sixty patients referred from department of oncology and surgery to pain clinic were allocated to two groups. In group A stellate ganglion block was performed with 8ml bupivacaine 0.25%. In group B, patients were treated with gabapentin 900mg per day in three divided doses. Drug dose was increased if necessary until eight weeks. Pain score and quality of life were determined. Data were collected before treatment, 48 hours and every 15 days after treatment until three months.

Results

Pain scores at 48 hours after treating were higher in group B than group A and lower at one week, one month and three months after treatment which were statically significant. (P<0.001, 0.024, 0.047 and <0.001 respectively)

Conclusion

In our study gabapentin was used as an ideal treatment technique for chronic pain following breast surgery.

post mastectomy, pain, stellate ganglion, gabapentin. post mastectomy, pain, stellate ganglion, gabapentin. 88 96 http://www.emedicalj.portal.tools/index.php?page=article&article_id=20814 H Hoseinzade H Hoseinzade Assistant Professor,Department of Anesthesiology, Tabriz University of Medical Science, Tabriz, Iran Assistant Professor,Department of Anesthesiology, Tabriz University of Medical Science, Tabriz, Iran Ata Mahmoodpoor Ata Mahmoodpoor Clinical Fellow in Critical Care Medicine, Department of Anesthesiology,Tabriz University of Medical Science, Tabriz, Iran; No. 423. Arman residental tower. 22nd Bahman Ave. Ashrafi Esfahani Highway, Tehran, Iran , +98-9141160888 Clinical Fellow in Critical Care Medicine, Department of Anesthesiology,Tabriz University of Medical Science, Tabriz, Iran; No. 423. Arman residental tower. 22nd Bahman Ave. Ashrafi Esfahani Highway, Tehran, Iran , +98-9141160888 D Agamohammadi D Agamohammadi Assistant Professor,Department of Anesthesiology, Tabriz University of Medical Science, Tabriz, Iran Assistant Professor,Department of Anesthesiology, Tabriz University of Medical Science, Tabriz, Iran S Sanaie S Sanaie General Practitioner, Tabriz University of Medical Science, Tabriz, Iran General Practitioner, Tabriz University of Medical Science, Tabriz, Iran
en The Top 50 Iranian Surgical Articles The Top 50 Iranian Surgical Articles research-article research-article Background

Citations are an important measure of the quality and content of scientific communica- tions. Since no study regarding the most cited surgical articles from Iran exists, this article aims to identi- fy these top cited articles.

Materials and Methods

The 50 most frequently cited articles in all fields of surgery originated from Iran were identified in database of Scopus in January 2007.

Results

The mean number of citations per article was 10. The most cited article received 54 citations, and the least cited article received 4. More than two-thirds of articles were published after 2000. Oph- thalmology and urology led the list of the surgical fields, each with 11 articles. A few articles in the field of general surgery were noted. There was not even an Iranian journal appeared on the list.

Conclusion

Conclusion: It can be concluded that although the number of citations of Iranian articles is far behind top-cited international articles, the current trend is promising.

Background

Citations are an important measure of the quality and content of scientific communica- tions. Since no study regarding the most cited surgical articles from Iran exists, this article aims to identi- fy these top cited articles.

Materials and Methods

The 50 most frequently cited articles in all fields of surgery originated from Iran were identified in database of Scopus in January 2007.

Results

The mean number of citations per article was 10. The most cited article received 54 citations, and the least cited article received 4. More than two-thirds of articles were published after 2000. Oph- thalmology and urology led the list of the surgical fields, each with 11 articles. A few articles in the field of general surgery were noted. There was not even an Iranian journal appeared on the list.

Conclusion

Conclusion: It can be concluded that although the number of citations of Iranian articles is far behind top-cited international articles, the current trend is promising.

citation, surgery, Iran. citation, surgery, Iran. 97 104 http://www.emedicalj.portal.tools/index.php?page=article&article_id=20816 A Aminian A Aminian Assistant Professor,Department of General Surgery, Imam Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran; Department of General Surgery, Imam Hospital Complex, End of Keshavarz Boulevard, Tehran, Iran , +98-2166937185 Assistant Professor,Department of General Surgery, Imam Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran; Department of General Surgery, Imam Hospital Complex, End of Keshavarz Boulevard, Tehran, Iran , +98-2166937185 R Mirsharifi R Mirsharifi Assistant Professor,Department of General Surgery, Imam Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran Assistant Professor,Department of General Surgery, Imam Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran A Jafarian A Jafarian Associate Professor, Department of General Surgery, Imam Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran Associate Professor, Department of General Surgery, Imam Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
en Spleen-Preserving Surgery Versus Splenectomy for Splenic Hydatid Cyst: Ten Years Experience Spleen-Preserving Surgery Versus Splenectomy for Splenic Hydatid Cyst: Ten Years Experience research-article research-article Background

Although rare,the spleen is the third most common location of hydatid disease after liver and lung. The aim of this study was to analyze the long-term outcome of surgical treatment of patients with splenic echinococcosis comparing spleen-preserving surgery with splenectomy.

Materials and Methods

During a period of 10 years (1996-2006), 20 patients with splenic echinococcosis entered our study as test and control groups. In our series the spleen was the only organ involved. Splenectomy was performed in the control group and spleen preserving drainage of cyst in test group.

Results

There was no significant difference between the splenectomy and spleen-preserving groups concerning median hospital stay, postoperative complication rate and recurrence. (p<0.5) The median follow-up in 15 patients was 52 (range 6-300) months.

Discussion

In the present series it was possible to preserve the spleen affected by hydatid cyst without significant increase of recurrent echinococcosis.

Background

Although rare,the spleen is the third most common location of hydatid disease after liver and lung. The aim of this study was to analyze the long-term outcome of surgical treatment of patients with splenic echinococcosis comparing spleen-preserving surgery with splenectomy.

Materials and Methods

During a period of 10 years (1996-2006), 20 patients with splenic echinococcosis entered our study as test and control groups. In our series the spleen was the only organ involved. Splenectomy was performed in the control group and spleen preserving drainage of cyst in test group.

Results

There was no significant difference between the splenectomy and spleen-preserving groups concerning median hospital stay, postoperative complication rate and recurrence. (p<0.5) The median follow-up in 15 patients was 52 (range 6-300) months.

Discussion

In the present series it was possible to preserve the spleen affected by hydatid cyst without significant increase of recurrent echinococcosis.

spleen, echinococcus, cyst, splenectomy, drainage. spleen, echinococcus, cyst, splenectomy, drainage. 82 87 http://www.emedicalj.portal.tools/index.php?page=article&article_id=20818 Sh Rahmani Sh Rahmani Assistant Professor, Department of Surgery, Shahid Beheshti University of Medical Sciences, Tehran, Iran Assistant Professor, Department of Surgery, Shahid Beheshti University of Medical Sciences, Tehran, Iran Arash Mohammadi Tofigh Arash Mohammadi Tofigh Assistant Professor, Department of Surgery, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Department of Surgery, Shahid Beheshti University of Medical Sciences, Tehran, Iran , +98-2177558081 Assistant Professor, Department of Surgery, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Department of Surgery, Shahid Beheshti University of Medical Sciences, Tehran, Iran , +98-2177558081
en Necrotizing Fasciitis -the Flesh Eating Bacterial Disease- of the Neck Necrotizing Fasciitis -the Flesh Eating Bacterial Disease- of the Neck case-report case-report

Necrotizing fasciitis is uncommon and can be difficult to diagnose. It causes progressive morbidity until the infectious process is diagnosed and properly treated. A delay in diagnosis is associated with a grave progno- sis and increased mortality. The main goal of the clinician must be to establish the diagnosis and initially treat the patient within the standard of care. We would like to present a case of 70-year-old gentleman with poorly controlled diabetes, who was diagnosed with type 1 primary necrotizing fasciitis of the neck and pre- sent the imaging findings which led to the diagnosis.

Necrotizing fasciitis is uncommon and can be difficult to diagnose. It causes progressive morbidity until the infectious process is diagnosed and properly treated. A delay in diagnosis is associated with a grave progno- sis and increased mortality. The main goal of the clinician must be to establish the diagnosis and initially treat the patient within the standard of care. We would like to present a case of 70-year-old gentleman with poorly controlled diabetes, who was diagnosed with type 1 primary necrotizing fasciitis of the neck and pre- sent the imaging findings which led to the diagnosis.

Necrotizing fasciitis, necrotizing cellulitis, Flesh eating disease, fasciitis necrotans, synergistic ne- crotizing cellulitis. Necrotizing fasciitis, necrotizing cellulitis, Flesh eating disease, fasciitis necrotans, synergistic ne- crotizing cellulitis. 105 112 http://www.emedicalj.portal.tools/index.php?page=article&article_id=20821 Masoud Shariat Masoud Shariat Radiologist, Medical Lecturer, Department of Radiology, Hospital Universiti Kebangsaan Malaysia, Cheras, Kuala Lumpur, Malaysia; Department of Radiology, Hospital Universiti Kebangsaan Malaysia, Cheras, Kuala Lumpur, Malaysia , +60-122175060 Radiologist, Medical Lecturer, Department of Radiology, Hospital Universiti Kebangsaan Malaysia, Cheras, Kuala Lumpur, Malaysia; Department of Radiology, Hospital Universiti Kebangsaan Malaysia, Cheras, Kuala Lumpur, Malaysia , +60-122175060 Z Mohammad Z Mohammad Associate Professor, Department of Radiology, Hospital Universiti Kebangsaan Malaysia, Cheras, Kuala Lumpur, Malaysia Associate Professor, Department of Radiology, Hospital Universiti Kebangsaan Malaysia, Cheras, Kuala Lumpur, Malaysia AH Hamzaini AH Hamzaini Radiologist, Medical Lecturer, Department of Radiology, Hospital Universiti Kebangsaan Malaysia, Cheras, Kuala Lumpur, Malaysia Radiologist, Medical Lecturer, Department of Radiology, Hospital Universiti Kebangsaan Malaysia, Cheras, Kuala Lumpur, Malaysia Ch Ping Kiat Ch Ping Kiat Medical officer, Department of Radiology, Hospital Universiti Kebangsaan Malaysia, Cheras, Kuala Lumpur, Malaysia Medical officer, Department of Radiology, Hospital Universiti Kebangsaan Malaysia, Cheras, Kuala Lumpur, Malaysia
en Role of N-Acetylglucosamine in Ca2+ and Mg2+ ions- regulated Fila- mentous Growth and Protein Glycosylation in C. albicans Role of N-Acetylglucosamine in Ca2+ and Mg2+ ions- regulated Fila- mentous Growth and Protein Glycosylation in C. albicans research-article research-article

Glucose or N-Acetylglucosamine induce similar filamentous growth and a specific calcium and magnesium-dependent intracellular glycoprotein pattern in C. albicans at 37 °C in vitro. Both filament growth and its associated glycoprotein pattern are inhibited by calcium ions. The above inhibition can be reversed by magnesium ions, though only in N-Acetylglucosamine- but not in glucose-treated cells. Our data show that in contrast to glucose, N-Acetylglucosamine more than being only a carbon source, it is a key factor for filamentous growth and intracellu- lar protein glycosylation to occur, and thus, it may effect the interaction of C. albicans with its host in a calcium- and magnesium-dependent manner.

Glucose or N-Acetylglucosamine induce similar filamentous growth and a specific calcium and magnesium-dependent intracellular glycoprotein pattern in C. albicans at 37 °C in vitro. Both filament growth and its associated glycoprotein pattern are inhibited by calcium ions. The above inhibition can be reversed by magnesium ions, though only in N-Acetylglucosamine- but not in glucose-treated cells. Our data show that in contrast to glucose, N-Acetylglucosamine more than being only a carbon source, it is a key factor for filamentous growth and intracellu- lar protein glycosylation to occur, and thus, it may effect the interaction of C. albicans with its host in a calcium- and magnesium-dependent manner.

C.albicans, filamentous growth, glycosylation, mannoproteins, N-Acetyl Glucosamine. C.albicans, filamentous growth, glycosylation, mannoproteins, N-Acetyl Glucosamine. 57 67 http://www.emedicalj.portal.tools/index.php?page=article&article_id=20823 M ER-RASFA M ER-RASFA Associate Professor, Laboratory of Pharmacology, Faculty of medicine and pharmacy, University of sidi Mohamed Ben Abdellah, Fez, Morocco; Laboratoire de Pharmacologie, Faculté de Médecine et de Pharmacie, Université Sidi Mohamed Ben Abdellah, Fez, 30000, Morocco , +212-35619320 Associate Professor, Laboratory of Pharmacology, Faculty of medicine and pharmacy, University of sidi Mohamed Ben Abdellah, Fez, Morocco; Laboratoire de Pharmacologie, Faculté de Médecine et de Pharmacie, Université Sidi Mohamed Ben Abdellah, Fez, 30000, Morocco , +212-35619320
en A Simple and Rapid DNA Purification Method for Detection of Leishma- nia DNA in Peripheral Blood of Patients with Visceral Leishmaniasis A Simple and Rapid DNA Purification Method for Detection of Leishma- nia DNA in Peripheral Blood of Patients with Visceral Leishmaniasis research-article research-article Introduction

Recently polymerase chain reaction technique is being used for detection of leishmania DNA in clinical samples of patients suspected with visceral leishmaniasis. Since many of the patients are children and also suffering from anemia and leucopenia, there is a need for the development of a DNA extraction method using small amount of clinical samples. In the present study, a simple and rapid method was introduced for performing the DNA extraction procedure which was capable of removing inhibitors from the whole blood sam- ples and of providing the appropriate DNA for Leishmania PCR amplification.

Materials and Methods

EDTA-peripheral blood specimens were collected from healthy volunteers and frozen at -20°C. The thawed specimens were spiked with a definite number of L. infantum promastigotes. Using in house made lysis buffer and boiling, a DNA extraction method was developed for the purification of Leishmania genome from 500 IJl of blood samples. The developed method was then compared with the classical standard method to obtain the highest sensitivity for the diagnosis of visceral leishmaniasis.

Results

The sensitivity of the PCR for the developed method was 10 copies of L. infantum DNA per reaction tube. When clinical samples collected from patients with a definite diagnosis of visceral leishmaniasis were used, no false negative was demonstrated with newly developed method.

Conclusion

Since hazardous materials such as phenol-chloroform are not used during extraction procedure, it seems to be much safer than the standard phenol-chloroform method. However, the use of small amount of sample (i.e. 0.5 IJl) and removal of PCR-inhibitors from the whole blood are the major advantages of our devel- oped DNA extraction method.

Introduction

Recently polymerase chain reaction technique is being used for detection of leishmania DNA in clinical samples of patients suspected with visceral leishmaniasis. Since many of the patients are children and also suffering from anemia and leucopenia, there is a need for the development of a DNA extraction method using small amount of clinical samples. In the present study, a simple and rapid method was introduced for performing the DNA extraction procedure which was capable of removing inhibitors from the whole blood sam- ples and of providing the appropriate DNA for Leishmania PCR amplification.

Materials and Methods

EDTA-peripheral blood specimens were collected from healthy volunteers and frozen at -20°C. The thawed specimens were spiked with a definite number of L. infantum promastigotes. Using in house made lysis buffer and boiling, a DNA extraction method was developed for the purification of Leishmania genome from 500 IJl of blood samples. The developed method was then compared with the classical standard method to obtain the highest sensitivity for the diagnosis of visceral leishmaniasis.

Results

The sensitivity of the PCR for the developed method was 10 copies of L. infantum DNA per reaction tube. When clinical samples collected from patients with a definite diagnosis of visceral leishmaniasis were used, no false negative was demonstrated with newly developed method.

Conclusion

Since hazardous materials such as phenol-chloroform are not used during extraction procedure, it seems to be much safer than the standard phenol-chloroform method. However, the use of small amount of sample (i.e. 0.5 IJl) and removal of PCR-inhibitors from the whole blood are the major advantages of our devel- oped DNA extraction method.

Leishmania, DNA purification, Peripheral blood. Leishmania, DNA purification, Peripheral blood. 75 81 http://www.emedicalj.portal.tools/index.php?page=article&article_id=20826 A Moaddeb A Moaddeb Instructor, Department of Microbiology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran Instructor, Department of Microbiology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran A Behzad-Behbahani A Behzad-Behbahani Associate Professor, Department of Molecular and clinical Virology, School of paramedical Sciences, Shiraz University of Medical Sciences, Shiraz, Iran; School of Paramedical Sciences, Meshkinfam Street, Shiraz, Iran , +98-7112295023 Associate Professor, Department of Molecular and clinical Virology, School of paramedical Sciences, Shiraz University of Medical Sciences, Shiraz, Iran; School of Paramedical Sciences, Meshkinfam Street, Shiraz, Iran , +98-7112295023
en Stroke Awareness in Two Rural Counties in Mississippi, USA. Stroke Awareness in Two Rural Counties in Mississippi, USA. research-article research-article

Mississippi has one of the highest stroke mortality rates in the nation. This paper present results of 2005 and 2006 surveys undertaken in an intervention and control county in rural Mississippi. A random-digit- dial (RDD) telephone surveys were conducted on adults 18 and older sampled from the civilian, non- institutionalized populations of Warren (control) and Washington (intervention) counties before and after implementing a 6-month long stroke awareness educational campaign in Washington County. The ana- lyzed results indicate that response rates to several of the questions increased after the intervention in Washington County, the results of this small sample survey do not show sufficient evidence to support any effect of the intervention. A significant lesson learned from this effort is that a more specific target popula- tion must be selected for intervention, and much tailored messages and appropriate media must also be identified and implemented.

Mississippi has one of the highest stroke mortality rates in the nation. This paper present results of 2005 and 2006 surveys undertaken in an intervention and control county in rural Mississippi. A random-digit- dial (RDD) telephone surveys were conducted on adults 18 and older sampled from the civilian, non- institutionalized populations of Warren (control) and Washington (intervention) counties before and after implementing a 6-month long stroke awareness educational campaign in Washington County. The ana- lyzed results indicate that response rates to several of the questions increased after the intervention in Washington County, the results of this small sample survey do not show sufficient evidence to support any effect of the intervention. A significant lesson learned from this effort is that a more specific target popula- tion must be selected for intervention, and much tailored messages and appropriate media must also be identified and implemented.

CVD, Surveys, Cardiovascular, Cardiovascular Disease, Community Health, Community Health CVD, Surveys, Cardiovascular, Cardiovascular Disease, Community Health, Community Health 68 74 http://www.emedicalj.portal.tools/index.php?page=article&article_id=20827 Mohammad Shahbazi Mohammad Shahbazi Associate Professor of Public Health and Acting Chair, Department of Behavioral and Environmental Health, School of Health Sciences, College of Public University of Mississippi Medical Center,; PhD, MPH, CHES, 350 W. Woodrow Wilson Ave., Suite 2301-B; Jackson, MS 39213. , +1(601)979-8845 Associate Professor of Public Health and Acting Chair, Department of Behavioral and Environmental Health, School of Health Sciences, College of Public University of Mississippi Medical Center,; PhD, MPH, CHES, 350 W. Woodrow Wilson Ave., Suite 2301-B; Jackson, MS 39213. , +1(601)979-8845 AD Penman AD Penman Associate Professor, Department of Medicine, University of Mississippi Medical Center, Associate Professor, Department of Medicine, University of Mississippi Medical Center, MM Yousef MM Yousef Department of Neurology, Ohio State University Medical Center Department of Neurology, Ohio State University Medical Center ML Mohamed ML Mohamed Faculty, College of Health Sciences, Walden University Faculty, College of Health Sciences, Walden University DF Sarpong DF Sarpong Associate Professor and Coordinator, Jackson Heart Study, Jackson State University, USA Associate Professor and Coordinator, Jackson Heart Study, Jackson State University, USA