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Showing 7 results for Esfandiari
"The Comparison Of Early Complication In Cholecystectomy After Endoscopic Sphinctrotomy With Cholecystectomy And Open Common Bile Duct Exploration 1999 - 2001 "
Resaei J, Esfandiari K,
Volume 62, Issue 3 (11 2004)
Abstract

Background: CBD stones are the commonest cause of obstructive jaundice and cholangitis and in elderly patients with major underlying disease has a high incidence of mortality.

Materials and Methods: In this study, we overviewed 200 patients with CBD stones which treated with cholecystectomy and Endoscopic sphinctrotomy or cholecystectomy and open CBD Exploration, and compare them for surgery complication, treatment failure and hospitalization complications.

Results: We found that these two groups were equal for surgery complication and morbidity. But in patients with Endoscopic sphinctrotomy they had added complication of this procedure. Failure in stone removal both immediately after procedure and in final assessment and costs was considerably higher in the patients that were treated with Endoscopic sphinctrotomy.

Conclusion: These results do not support preoperative Endoscopic sphinctrotomy as a technique for stone removal on the basis of efficacy, morbidity rate and cost. But overall conclusion about comparison of two methods is dependant to other studies about long term morbidity and other factors that affect results.


Laparoscopic placement of peritoneal dialysis catheters in CAPD patients: complications and survival
Ashegh H, Rezaii J, Esfandiari K, Roueentan A, Abouzari M,
Volume 66, Issue 3 (2 2008)
Abstract

Background: Laparoscopic techniques for the placement of peritoneal dialysis catheters are becoming increasingly popular. Recently, with the improvements in laparoscopic surgery, various methods for the insertion of peritoneal dialysis catheters have been reported, indicating that the laparoscopic insertion is preferred over the open and percutaneous techniques. The aim of this study was to introduce and assess a simplified laparoscopic method for the insertion of peritoneal dialysis catheters in continuous ambulatory peritoneal dialysis (CAPD) patients.
Methods: We enrolled 79 consecutive end-stage renal patients (46 men and 33 women) with a mean age of 50 years (range: 19-83 years) in this study. During the surgery, a 5-mm trocar was placed in the left upper quadrant for the optics and another 5-mm trocar was placed to the left of the umbilicus. Using the second trocar, a tunnel was formed 2 cm left of the umbilical plane for the insertion of a Tenckhoff catheter. Under direct vision, the catheter was advanced into the abdomen. The catheter was tested for patency. Catheters of all subjects were capped for two weeks before dialysis initiation.
Results: The mean duration of the operation was 15 minutes. Ten patients died during the follow-up period, all due to other medical problems, and six patients underwent renal transplantation however, no deaths or complications were observed during surgery. Early onset complications were seen in 12 patients (15.1%). The most frequent late-onset medical and mechanical complications were peritonitis (6.3%) and hernia (3.7%). During a follow-up period of four years, removal of the catheter was required in two patients as a result of peritonitis.
Conclusion: We obtained a low complication rate and a high catheter survival rate with this laparoscopic insertion of the Tenckhoff catheter. We believe future experience will encourage the use of this safe, simple and quick procedure.


Gastric pull-up versus pectoralis major myocutaneous flap techniques in hypopharyngeal cancer: comparison of complications
Rezaii J, Esfandiari Kh, Khalili Pooya J, Tavakoli H, Abdolrahman R, Salamati P, Abouzari M,
Volume 66, Issue 6 (5 2008)
Abstract

Background: Hypopharyngeal cancer usually presents with cervical mass, hoarseness, radiated otalgia, and dysphagea in the advanced stages. Radical surgery followed by radiotherapy plays an important role in the treatment of patients with hypopharyngeal cancer. However, there is no general consensus as to which is the best method of reconstruction after surgical resection. The aim of this study was to evaluate the complications of pectoralis major myocutaneous flap (PMMF) and gastric pull-up (GPU) techniques to reconstruct a circumferential defect after laryngopharyngoeso- phagectomy.

Methods: We retrospectively reviewed the records of 64 patients who underwent radical surgery and reconstruction with either PMMF or GPU technique. Demographic characteristics, tumor location, proximal margin involvement, history of radiotherapy, presence of lymphadenopathy, cervical dissection, and postoperative complications such as fistula, anastomotic site stenosis, swallowing dysfunction, and stoma stenosis were compared between the two groups. Postoperative complications of the reconstruction methods were compared.

Results: A total of 64 patients, 43(67%) in GPU group and 21(33%) in PMMF group, were studied. The groups did not differ in demographic characteristics. The locations of the tumoral lesions were in larynx (n=7), proximal esophagus (n=5), posterior cricoid (n=5), pyriformis sinus (n=7), posterior wall (n=7), and miscellaneous (n=41). Six patients (6.3%) had proximal margin involvement, 19 patients (29.9%) had history of radiotherapy, 26 cases (40.6%) had lymphadenopathy, and 49 cases (76.5%) had cervical dissection. There was no significant difference between the two groups regarding stenosis or swallowing dysfunction rates, but fistula was seen lower following GPU compared with PMMF (p<0.001).

Conclusions: The GPU technique results in similar functional stenosis or swallowing dysfunction rates, but lower fistula compared with PMMF reconstruction.


Evaluation of mupirocin ointment in control of central venous catheter related infections: a randomized clinical trial
Jalal Rezaei, Khalil Esfandiari, Hassan Tavakoli , Mahmood Sadooghi , Mehrdad Hasibi , Mehrdad Behzadi ,
Volume 67, Issue 6 (9-2009)
Abstract
Background: Central venous catheter (CVC) related infections are important complications of cathter application. This study assessed the usefulness of mupirocin in prevention and control of these infections.
Methods: In this randomized clinical trial, consecutive surgical patients requiring central venous catheter (for more than 2 days) in Amir-Alam Hospital from 2006-2008 were enrolled. Patients were divided in two groups in “case group” patients received topical mupirocin 2% every 48 hours at the time of insertion of catheter and dressing change and for “control group” mupirocin was not used. All of the patients received chlorhexidine and enoxoparin as complementary treatments. Two groups were comparable in regard of age, sex and risk factors.
Results: One hundred eighteen patients enrolled in the study (57 in case and 61 in control group) completed the study. 84 catheters in case group and 88 catheters in control group were inserted. The catheters in 90% of patients were inserted in jugular vein. At the end of study 29(16.8%) patients (16 in control versus 13 in case group) had catheter colonization (p=NS). Catheter related bloodstream infection was observed in 16(9.3%) patients (6 in case versus 10 in control group) (p=NS).Catheter related local infection was seen in 2(1.1%) patients of control versus none of mupirocin group. (p=NS).
Conclusions: Mupirocin was not effective to control and prevention of bacterial colonization and catheter related infection.

A review on epidemiology of Clostridium difficile infection
Zahra Esfandiari , Mohammad Jalali , Leila Safaeian, J Scott Weese ,
Volume 74, Issue 5 (August 2016)
Abstract

Clostridium difficile (C. difficile) is an important factor in the development of the gastrointestinal diseases because of irrational antibiotic prescription and antimicrobial resistance. In the past, this bacterium was introduced as an agent of the infection in the hospitals called "hospital acquired Clostridium difficile infection". This infection is a main cause of morbidity and mortality internationally. But changing in the epidemiology of the infection was observed in recent years. People not taking antibiotics as well as any contact with the clinical system were hospitalized due to the infection named "Community-Associated Clostridium difficile infection". Furthermore, the hypervirulent strains of C. difficile were identified outside of the health care facilities in different sources such as environment, animals and food products. Today the role of C. difficile has not been confirmed as a zoonotic agent or foodborne pathogen. Taking into account, it should be taken attention to the sensitive individuals such as pregnant women, elderly and children for the consumption of the contaminated food products with C. difficile spores and probable cause of the infection in these individuals. For this purpose, presentation of the guidelines or the prevention strategies for the transmission of bacteria in the society as well as the healthcare facilities is important. In this review study, the history, the risk factors of disease and the reports of infection in the healthcare facilities and outside of this environment in Iran were discussed. Finally, we supposed that based on the isolation of C. difficile with different genetic profile in Iran in comparison with international ribotypes, the existence of native strains leading to the infection in the community and the healthcare facilities is possible. This hypothesis shows the significance of regional differences in the epidemiology and microbiology of disease. In addition, according to the present reports on the irrational prescription of the antibiotics in our country, it seems that C. difficile infection is increasing but any continuous monitoring is not being occurred for the supervision in Iran. Approving these hypotheses need to the careful and continuous assessment besides comprehensive examination of molecular epidemiology of disease in the organizations related to the health in Iran.


Influence of education on knowledge, attitude and practices of students of Isfahan University of Medical Sciences to traffic light inserted on food labeling
Zahra Esfandiari, Mohammad Reza Marasi , Fatemeh Estaki , Vahid Sanati , Elnaz Panahi , Nader Akbari , Roya Alsadat Madani, Jila Mosberian Tanha ,
Volume 77, Issue 1 (April 2019)
Abstract
Background: Nutrition education and introduction of procedures for choosing healthier food have an important role to reduce the rate of non-communicable diseases. It was shown the amount of risk factors of non-communicable diseases such as energy, salt, sugar, fat and trans fatty acid on the traffic light of food labelling. The status of risk is presented through three colors of red, yellow and green that are the signs of risk, precautious and safe use of food. The object of this study was to evaluate the influence of education on the knowledge, attitude and practices of Isfahan University of Medical Sciences students to the traffic light on food labeling.
Methods: This project was an empirical study performed by random sampling of 379 students of nine schools in Isfahan University of Medical Sciences from January 2017 to March 2018. The knowledge, attitude and practices of students toward the traffic light were assessed by self-administered and structured questionnaire. Education was performed face to face with the usage of pamphlet. In the period of three to six months, questionnaires were refilled out by students to determine knowledge, attitude and practice. Descriptive statistics were calculated using SPSS in mean± SD. Paired t-test was performed to assess the influence of education in total score of knowledge, attitudes and practices in test-retest. P value was considered less than 0.05 as statistically significant.
Results: Before education, the average of scores for knowledge, attitude and practice was 1.12±0.84, 14.44±4 and 2.25±2.2, respectively. Afterwards, the scores were increased to 11.72±0.75, 18.67±3.18 and 17.69±4.7 after education. Significant difference was observed in the scores of knowledge, attitude and practice of students before and after education (P<0.05).
Conclusion: Education of traffic light had a significant role in the improvement of knowledge, attitude and to some extent of practice of students in selection of healthier food.

Controlling and prevention of novel coronavirus through health and safety protocols in food: review article
Zahra Esfandiari, Fatemeh Amani, Meraj Pourhossein, Hedayat Hosseini,
Volume 78, Issue 12 (March 2021)
Abstract
The development of industry and technology, changes in agriculture, trade and global travel, and the adaptation of microorganisms are important factors in the occurrence of emerging diseases. Currently, the world is facing a pandemic caused by an emerging virus called the novel coronavirus (Covid 19) in 2020. This disease led to infect more than one million people worldwide and the death of more than five hundred thousand people during six months. Covid 19 causes death in patients with respiratory problems of varying severity. Fever, soreness, dry coughs, shortness of breath, runny nose, and nasal congestion were observed in coronavirus-infected individuals. Fever was one of its common symptoms. Other unusual signs such as diarrhea and nausea were reported for this disease. For the first time, the bat was introduced as the host of the novel coronavirus in China. Therefore, identifying the initial route of transmission of the novel coronavirus is necessary to prevent the occurrence and its widespread distribution. The virus enters into a human through respiratory particles as well as touching the surfaces contaminated by nasal, mouth and eye secretions. Viruses are obligate intracellular pathogens needing host cells to survive. These microorganisms cannot proliferate in foods and require live cells for existence. Food is introduced as a carrier of viruses to the consumer. There have been no reports of novel coronavirus transmission through food. However, it is important to observe the principles of health and safety by assuming the spread of the virus due to food contamination. Regarding the presence and proliferation of novel coronavirus in the gastrointestinal tract and aerosol formation of this microorganism in the feces and the possibility of re-transmitting it to people from various environmental sources, the most important priority is to remove the virus from food environments. It is also important to update the methods of disinfecting surfaces, especially areas with high contact of hand as well as personal hygiene. Therefore, it is recommended to educate the staff about managing the novel coronavirus and improving health guidelines. Furthermore, keeping distance and washing hands is in priority in different food-related environments.

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