Showing 8 results for Khorasani
Khorasani B, Gholizadeyeh Pasha A,
Volume 64, Issue 8 (13 2006)
Abstract
Background: The early diagnosis of acute appendicitis before progression to gangrene or abscess formation is recognized as important to minimize morbidity from this common disease process. The aim of this study was to assess the value of different risk factors in the diagnosis of perforation.
Methods: This descriptive-analytic and retrospective study was conducted to investigate epidemiological characteristics in patients with perforated and non-perforated appendicitis. A series of 1311 patients who were operated on for acute appendicitis between years 1380-1382 in Shahid Beheshti and Yahya-nejad hospitals were reviewed.. Data gathered included age at operation, gender, care sought prior to admission for appendectomy including antibiotic and analgesic therapy, time of presentation in the year, duration of symptoms, signs and symptoms at the time of admission, and the patient’s living area.
Results: One hundred twenty one of 1311 patients (9%) had perforated appendicitis and 1190 patients (91%) had unperforated appendicitis. Presentation and referral in the first 6-month was associated with higher perforation rate. Patients from rural area showed a higher rate of perforations. The perforation rate was significantly higher in elderly patients (>65 year). When the duration of symptoms was more than 12 hours at presentation, the risk of perforation showed a five-fold increase. 30.7% of perforated cases had used antibiotic or sedative before referring to the hospital.
Conclusion: Appendiceal perforation continues to be a complication in patients with acute appendicitis and increased in the frequency as the age of the patients increase and the duration of symptoms lengthen. We also found that the perforation rate is higher in patients from rural area and in whom present in the first 6-month of the year, a finding that was not reported so far.
Fallahi Gh, Farahmand F, Nematkhorasani E,
Volume 65, Issue 4 (3 2007)
Abstract
Background: Neonatal cholestasis is an important disease of the liver and biliary ducts in infancy. In neglected cases, the disease has irreversible complications. Idiopathic neonatal hepatitis, biliary atresia, TORCH infections and choledochal cyst are important causes of neonatal cholestasis. The aim of this study was to determine the causes of cholestasis among neonates admitted to the Children’s Medical Center of Tehran University.
Methods: This is a descriptive, retrospective study including 109 patients diagnosed with obstructive icterus, from 1994 to 2001. With data collected from hospital records, the inclusion criteria consisted of cholestasis with a conjugated bilirubin of up to 2 mg/dl from at least two laboratory samples (20% of total bilirubin). The definitive diagnosis of cholestasis included the laboratory investigations, which were in the patients’ hospital records and documented by their physicians.
Results: Our patients (63 males and 46 females) had a mean age of 40±6 days. The most common clinical findings were icterus, acholic stool and hepatosplenomegaly. The most common cause of cholestasis was idiopathic neonatal hepatitis followed by biliary atresia, which together caused 75% of all the cases in this study.
Conclusions: In our general population, the most common causes of neonatal cholestasis are hepatitis and biliary atresia. In other investigations, the etiology of neonatal cholestasis was different than that of this study. Because the number of different disorders presenting with cholestasis may be greater during the neonatal stage than at any other time of life, early diagnosis and treatment is very important for improved prognosis.
Ghasemali Khorasani , Omid Hasani , Mohamadreza Farahvash ,
Volume 68, Issue 8 (November 2010)
Abstract
Background: Proper nasal tip control is a difficult step in rhinoplasty. The aim of this study was to compare the effects of two cartilage modifying methods, Septocolumellar Suture (SCS) and Lateral Crural Overlay (LCO), on nasal tip projection and rotation.
Methods: In a single-blinded clinical trial, 36 patients who were scheduled for nasal tip deprojection were enrolled. A profile photograph of face was taken from all the patients before and three months post operation. Nasofacial angles, TP:Ln ratio for assessing nasal tip projection, tip columellar angle and nasolabial angles for nasal tip rotation assessment were measured by a computer software. The patients were randomly divided into two groups that underwent open rhinoplasty.
Results: Both the LCO and SCS methods were accompanied by a significant reduction in nasofacial angle and TP:Ln ratio, there was raised nasolabial and rotation angle in comparison to preoperative values. The use of LCO method in comparison to SCS resulted in more increase in the nasolabial angle (11.83±3.05 Vs. 4.56±1.62 degree) and Rotation Angle (11.44±3.22 Vs. 1.56±1.04 degree) and resulted in more reduction in post-operative TP:Ln ratio in comparison to preoperative measures (-0.05±0.01 Vs. -0.03±0.01), however, the difference in the nasofacial angle was not significant.
Conclusion: Both cartilage modifying techniques resulted in significant reduction in the projection and increasing in the tip rotation. Lateral Crural Overlay (LCO) seems to be more effective than Septocolumellar Suture (SCS). Therefore, the SCS method is recommended for patients who need more nasal tip rotation and deprojection in rhinoplasty.
Farahvash Mr, Yegane R, Khorasani Gh, Ahmadi M, Farahvash B,
Volume 69, Issue 6 (6 2011)
Abstract
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Background: Anthropometric facial analysis and quantitative measurements are useful methods
for diagnosis, as well as planning in plastic surgery. The literature is
replete with numerous related studies, few of which are about the Iranian
population. This study was conducted to determine the average facial
proportions of Iranians and compare it with that of Caucasians.
Methods: This cross-sectional study was conducted on a convenient sample of 212
Iranians (male=108, female=104)
aged 18-30 years who did not have any previous major
facial surgery or trauma and their past two generations were Iranian.
Measurements between facial landmarks were determined and compared with
Caucasians with Student and one sample t-tests (P<0.05, 95%
CI).
Results: The intercanthal (en-en) and eye widths (ex-en/R),
forehead height 2 (tr-n), trichion-endocanthion
(tr-en) and nasofacial and nasofrontal angles were not significantly different between
the participating men and women but other facial measurements were
significantly different (Р<0.05).
The head (ft-ft), eye (ex-en/R/L) and nose widths
(al-al) and upper face height (n-sto), nasofrontal angle and nasal tip
protrusion in the study population were not significantly different from
Caucasians. The upper lip (sn-sto), lower face (sn-gn) and forehead heights
(tr-n) and nasofacial angle of the female participants were not significantly
different from Caucasian women but other facial measurements were significantly
different (Р<0.05).
Conclusion: Most
facial anthropometric measurements of Iranian subjects were significantly different
from those of Caucasians. More precise studies with larger sample sizes are
warranted to reach a common conclusion on the facial anthropometric similarities
or differences between the two populations.
Hussain Khan Z, Eskandari Sh, Rahimi M, Makarem J, Meysamie A, Khorasani Am, Zebardast J,
Volume 70, Issue 6 (5 2012)
Abstract
Background: Inadequate ventilation, esophageal intubation and difficult intubation are the most common adverse respiratory outcomes in patient undergoing anesthesia .The aim of this study was to compare Mallampati test in supine and sitting positions in traditional approach and during phonation for predicting difficult laryngoscopy and intubation.
Methods: In this study performed in Imam Khomeini Hospital in Tehran, Iran, Mallampati test was performed on 661 patients who met the inclusion criteria for the study. The test was done in supine and sitting positions with and without phonation by a rater who was blind to Mallampati test. Subsequently, laryngoscopy view and difficult intubation were evaluated in the four aforesaid positions by Mallampati test for predicting difficult laryngoscopy and intubation. For each situations, sensitivity, specificity, positive and negative predictive values and accuracy were calculated.
Results: Overall, 28 (4.2%) patients had difficult laryngoscopy and 9 (1.4%) patients had difficult intubation. The highest sensitivity for Mallampati test in predicting difficult laryngoscopy and intubation was in supine and sitting positions without phonation, and the highest specificity was seen in sitting position with phonation. Negative predictive values were more than 95% in all different positions for Mallampati tests and the highest positive predictive value was seen in supine position with phonation.
Conclusion: According to our findings, the highest correlation between Mallampati test and different positions in predicting difficult laryngoscopy and intubation was seen in supine position with phonation. Phonation improved Mallampati score in supine rather than sitting position.
Ghasemali Khorasani , Siamak Rakei , Amirhosein Tavakoli ,
Volume 74, Issue 2 (May 2016)
Abstract
Background: Cartilage grafting is used in rhinoplasty and reconstructive surgeries. Autologous rib and nasal septum cartilage (auto graft) is the preferred source of graft material in rhinoplasty, however, homologous cartilage (allograft) has been extensively used to correct the nasal framework in nasal deformities. Autologous cartilage graft usage is restricted with complication of operation and limiting availability of tissue for extensive deformities. Alternatively, preserved costal cartilage allograft represents a readily available and easily contoured material. The current study was a formal systematic review of complications associated with autologous versus homologous cartilage grafting in rhinoplasty patients.
Methods: In this cohort retrospective study, a total of 124 patients undergone primary or revision rhinoplasty using homologous or autologus grafts with postoperative follow-up ranging from 6 to 60 months were studied. The types of grafts and complications related to the grafts were evaluated. This included evaluation for warping, infection, resorption, mobility and fracture.
Results: The total complications related to the cartilage grafts were 7 cases, which included 1 warped in auto graft group, three cases of graft displacement (two in allograft group and one in auto graft group) and three fractures in allograft group. No infection and resorption was recorded. Complication rate (confidence interval 0.95) in autologous and homologous group were 1.25(0.4-3.88) and 2.08(0.78-5.55) in 1000 months follow up. There was no statistically significant difference between autologous and homologous group complications. Onset of complication in autologous and homologous group were 51.23(49.27-53.19) and 58.7(54.51-62.91) month respectively (P=0.81).
Conclusion: The allograft cartilage has the advantage of avoiding donor-site scar. Moreover, it provides the same benefits as autologous costal cartilage with comparable complication rate. Therefore, it can be a reliable alternative material for rhinoplasty surgeries. A longer follow-up may be necessary to confirm the structural stability of the allograft cartilage grafts.
Shayesteh Khorasanizadeh , Faranak Behnaz , Masih Ebrahimy Dehkordy , Houman Teymourian , Homeyra Kouzekanani ,
Volume 77, Issue 6 (September 2019)
Abstract
Background: Hypoglycemia is a condition when blood glucose level is lower than 70 mg/dl in people without diabetes. The symptoms of hypoglycemia include tachycardia, sweating, pallor, pupillary dilatation. Hypoglycemia is a non-lethal and often preventable clinical problem in non-diabetic patients that can occur during fasting or after dining.
Case presentation: A 52 years old man referred to Shohada-e-Tajrish Hospital, Tehran, with diagnosis of kidney stones candidate for percutaneous nephrolithotomy (PCNL). The patient underwent general anesthesia and after 40 minutes, the surgeon requested injection of tranexamic acid because of bleeding, but unintentionally the patient received 100 unites of crystalline insulin by nurse anesthesia. Vital signs were stable, the patient's blood glucose was 85 mg/dl and he had no sweat. Then the therapeutic intervention consisted of administering a bolus dose of 50 cc 50% dextrose water (DW) and then infusion of 50% dextrose water over that time. The patient was monitored for 10 hours in recovery and also received 1 mg of glucagon. The blood glucose was checked frequently. Fortunately, there were not any detectable hypoglycemic attacks (blood glucose less than 70 mg/dl) during that time. Throughout the first three hours in ICU, he suffered from severe hypoglycemic episodes and treated by DW 50% (bolus stat and infusion) and after stabilization of vital signs he transferred to ward.
Conclusion: The mortality of iatrogenic hypoglycemia is lower than other causes of hypoglycemia. However, on time diagnosis and aggressive treatment can prevent serious complications. In addition, proper communication between health care providers and precise checking of drugs labels before injection can dramatically decrease these events.
Hamidreza Azizi Faresani , Shayesteh Khorasanizadeh, Noormohammad Arefian , Houman Teymourian , Gholamreza Mohseni , Faranak Behnaz , Hamideh Ariannia ,
Volume 79, Issue 5 (August 2021)
Abstract
Background: This study aimed to evaluate the effect of intravenous Ibuprofen Apotel analgesia in comparison with intravenous Morphine alone regimen in patients undergoing lubmar disc surgery.
Methods: This study was a double-blind clinical trial that was performed on patients with moderate to severe lumbar disc pain (VAS score or Visual analog scale more than 4) in August 2019 at Shohada Tajrish hospital. Patients in the Ibuprofen-Apotel group (group A) recieved intravenous Ibuprofen (800 mg) in 100 cc Normal saline in the first 30 minutes of Recovery, then 400 mg in 100 cc Normal saline every 6 hours (48 hours after surgery), plus 30 mg Apotel for each kilogram in100 cc Normal saline in 15 minutes every 8 hours. In group B, Morphine has injected with 70 µg/kg bolus and then 20µg/kg/h infused with a PCA pump with a Maximum Rate of 1mg/hr. Then 60 minutes after surgery, patients' pain was measured using an analog scale.
The primary outcome was defined as a reduction in pain intensity of 3 or more VAS units (which was considered as therapeutic success) and the incidence of side effects was considered as secondary outcomes.
Results: Based on the results of this study, the mean age of the subjects was 33.28±12.48 years. Also, the mean age in the group of Ibuprofen-Apotel and Morphine alone were 35.4±13.6 and 31.16±11.75 years. So, there is not a significant difference between the groups. 77.14% of the subjects (54 people) were male and 22.86% (16 people) were women. In comparing the frequency distribution of individuals in terms of gender and the method of creating analgesia, no significant difference was observed between the groups studied.
According to the results, after the intervention, the highest pain intensity in both groups was significantly decreased. However, no significant difference was observed between the two groups.
Conclusion: The study indicated that Ibuprofen can be effective in controlling postoperative pain.