Showing 5 results for Khashayar
Ravari H, Ghaemi M, Vojdani A, Khashayar P,
Volume 65, Issue 10 (2 2008)
Abstract
Background: About one-forth of the patients admitted to the emergency department complain of acute abdominal pain. According to surgical records, most surgeons believe that pain relief for these patients may interfere with the clinical examinations and the final diagnoses. As a result, analgesics are withheld in patients with acute abdominal pain until the determination of a definite diagnosis and suitable management plan. The purpose of this study was to evaluate the effect of analgesics on the evaluation course and treatment in acute abdomen.
Methods: Two hundred patients at a surgical emergency department with acute abdominal pain were enrolled in this prospective study and randomly divided into two groups at the time of admission. The case group consisted of 98 patients who received intravenous analgesia immediately after admission. The other 102 patients in the control group did not receive analgesia until a definite diagnosis was made. Diagnostic and therapeutic procedures were similar between the two groups. The primary and final diagnoses, and the time intervals between the admission and definite diagnosis, and that between admission and surgery were gathered and analyzed.
Results: The mean time to definitive diagnosis was 1.7 and 2.04 hours in the case and control groups, respectively. There was no statistically significant relationship between analgesic use and gender, age, time to definite diagnosis, or accuracy of the diagnosis. In fact, the time required to achieve a definite diagnosis and the time between admission and surgery were less in the group that had received analgesics.
Conclusions: In spite of the fact that analgesics remove the very symptoms that brings patients to the emergency room, appropriate use of analgesics does not reduce diagnostic efficiency for patients with acute abdominal pain.
Ahmadi Amoli H, Zafarghandi Mr, Tavakoli H, Davoodi M, Khashayar P,
Volume 66, Issue 11 (3 2009)
Abstract
Background: Trauma is a common problem in the world, predominately affecting young adults. Considering the high mortality rate in patients suffering from thoracic trauma, the condition is considered to be extremely important. The purpose of this study was to evaluate the prevalence and the epidemiology of chest trauma as well as the severity of the resulted injury in Tehran, Iran.
Methods: This prospective, descriptive study was conducted on patients admitted to three medical centers in Tehran during June 1997 and 1998 due to chest trauma. The data on the demographic information of the patients, the mechanism of the trauma and the severity of the injury were collected and analyzed.
Results: Three hundred forty two patients were admitted to hospital due to thoracic trauma the majority of which were male adults. Blunt trauma especially secondary to motor vehicle accidents were the most frequent cause of chest injury in the studied patients. In 280(82%) of the cases, another form of trauma was also reported. Chest wall injury was the most common type of thoracic trauma in these patients. The trauma was reported to be mild in 181(53%) of the patients (ISS<7). Only 42(12%) patients required surgical intervention. The overall mortality rate was 14% which was reported to be ISS- related.
Conclusion: Chest injury is quite prevalent among trauma patients and is associated with other injuries in a considerable number of the patients. This type of trauma is associated with a high mortality rate among elderly and therefore needs special attention and care.
Shariat Moharari R, Parsaee M, Najafi A, Ebrahim Soltani Ar, Khajavi Mr, Khashayar P,
Volume 66, Issue 12 (5 2009)
Abstract
Background: Axillary block is used for inducing anesthesia in outpatient hand and forearm surgeries. Few researches have studied hemodynamic and blockade effects of low doses of Epinephrine. The aim of the present study was to compare the duration of analgesia and hemodynamic changes following the injection of high/low epinephrine doses in such surgeries.
Methods: The present randomized clinical trial study was conducted on healthy individuals (ASA I-II) who were candidates for hand and forearm surgeries. The patients were randomly divided into three groups. The first two groups were allocated to receive lidocaine with low (0.6µg/cc) and high (5µg/cc) doses of epinephrine whereas lidocaine plus normal saline was injected in the third group. The hemodynamic changes (Mean arterial blood pressure and heart rate) and the occurance of any side-effects along with the duration of analgesia and motor block were recorded.
Results: From among the total of 75 patients, 15 cases were excluded due to incomplete blockade or failure needing general anesthesia. The duration of analgesia and the motor block were longer in the high dose epinephrine group, the difference, however, was not statistically significant. Heart rate changes within the groups was significant in the 4th-7th and 10th minutes. Mean arterial blood pressure changes was only significant in the 4th minute, within the groups.
Conclusions: Administering low doses of epinephrine plus lidocaine as a local anesthetic not only provides acceptable analgesia compared to higher doses of the medication, but also is associated with fewer side effects.
Mahdieh Shojaa, Mehrdad Aghaie , Mahsa Amoli , Patricia Khashayar , Naemeh Javid, Fatemeh Shakeri, Mostafa Qorbani , Ramin Mohebbi,
Volume 73, Issue 2 (May 2015)
Abstract
Background: Cytotoxic lymphocyte antigen-4 (CTLA-4) plays an important role in regulating T cell activation. CTLA-4 gene polymorphisms are related with genetic susceptibility to various autoimmune diseases, including systemic lupus erythematosus (SLE). We analyzed the role of CTLA-4 polymorphisms at positions -318CT in patients who suffer from SLE.
Methods: This study was performed on 180 SLE patients referred to 5th Azar University Hospital in Gorgan, Iran. Three hundred and four ethnically-and age-matched healthy controls with no history of autoimmune diseases entered the study between 5th May 2008 and 23rd October 2009. DNA was extracted from blood samples according to the standard procedure. Polymerase chain reaction- restriction fragments length polymorphism (PCR-RFLP) was used to analyze the genotype and allele frequencies of this polymorphism. PCR was carried out using the following primers: forward 5′-AAATGAATTGGACTGGATGGT-3′ and reverse 5′-TTACGAGAAAGGAAGCCGT G-3′. The frequency of alleles and genotypes were assessed using direct counting. Chi-square test and Fisher’s exact test were used to compare the association between the alleles and genotype frequencies and SLE. P<0.05 were considered statistically significant.
Results: The CC genotype was observed in 94.5% of the SLE patients and 82.4% of the controls the difference was statistically significant (P=0.0001, OR=3.51, CI95%=1.77-7.53). The CT genotype, on the other hand, was more frequently observed in the control group (17.1% vs. 5.5%, P=0.0001, OR=0.28). T allele was significantly more common in the controls compared to SLE patients (P=0.0001, OR=0.26, CI95%=0.13-0.53).
Conclusion: Our results suggest that the -318C/T polymorphism of CTLA-4 gene might play a significant role in the genetic susceptibility to SLE. Therefore, further studies on populations, especially from other Middle East countries, are needed to confirm our results.
Ali Samady Khanghah , Maryam Khalesi , Department of Pediatrics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran Hokmabadi, Khashayar Atqiaee,
Volume 81, Issue 8 (November 2023)
Abstract
Background: Crohn's disease is considered a heterogeneous disorder with multi-factorial etiologies, in which the interaction of genetics and environment manifests the disease. Adverse childhood experiences can affect future physical and mental health outcomes. The rich innervation of the intestine with the Vagus nerve and hormonal interactions on the one hand and the constant contact of the digestive system with various pathogenic and non-pathogenic antigens have a proven role in autoimmune diseases and can gradually be chosen as a therapeutic goal.
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Case Presentation: We are reporting a case of Crohn's flare-up after trauma in a pediatric case. A 2.5-year-old male with a through and through anal trauma was presented in Akbar Children's Hospital, Mashhad, Iran, Spring 2023 with active bleeding but conscious. He then underwent a physical examination under general anesthesia in the operating room. At the Lithotomy position, a penetrating wound at the 3 o'clock anal verge and a tear in the perineal area at 9 o'clock, which, according to the evidence of pus discharge, were seen hours after the incident which was irrigated with normal saline and Hydrogen Peroxide respectively. Due to the contamination of the area, a supportive colostomy was decided to be closed after six months. At the appointed time during the colonoscopy, the pediatric gastroenterologist noticed extensive inflammation in the distal patch of the colon, which was consistent with Crohn's disease. Histopathological studies then confirmed this diagnosis. This was even though there were no symptoms of inflammatory bowel disease in the history of the boy's illness before the accident. The patient is then treated with prednisolone, Asacol, and ciprofloxacin, and after the disease subsides, the colostomy surgery team closes the disease.
Conclusion: Trauma can be an immune-disrupting factor in the digestive system, and trying to reset the brain-gut axis can be chosen as a therapeutic goal.
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