Showing 5 results for Mirjafari
Abbas Alibakhshi , Saeid Safari , Hamid Ghaderi , Ali Aminian , Yasra Jahangiri , Seyedeh Adeleh Mirjafari Daryasari ,
Volume 67, Issue 10 (1-2010)
Abstract
Background: Management of acute abdomen usually does not necessitate accurate pre-operative diagnosis but the surgeon should make a decision about the need for emergent laparotomy. This fact is somehow different for localized peritonitis (e.g. acute appendicitis) in which the clinical presentation directs straightly to the diagnosis. However, acute appendicitis has lots of differential diagnoses, finding the normal appendix during laparotomy is just a start point to look for other diagnoses. Omental torsion is a rare cause for acute abdomen that is usually missed. Knowing about this rare condition and its frequently encountered presentation at the operating room (sero-sanguinous fluid coming out of peritoneal cavity) may prevent missing the diagnosis and doing a malpractice.
Case report: Report a 9 year- old boy presented with acute abdomen which turned out to be an omental torsion after the operation.
Conclusion: Knowledge about this rare condition "omental torsion" and its clinical and intra operative presentations may prevent missing the diagnosis and a malpractice.
Hamid Ghaderi, Kourosh Shamimi, Fereydoon Moazzami, Seyed Hasan Emami Razavi, Ali Aminian, Seyed Mehdi Jalali, Reza Afghani, Morteza Noaparast, Seyyed Habibollah Dashti, Saeed Safari, Alireza Ahmadvand, Seyede Adeleh Mirjafari Daryasari, Fatemeh Sadat Naeemie,
Volume 68, Issue 1 (4 2010)
Abstract
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Background: Appendicitis is more common during the second
and third decade of life and appendectomy scar is important in terms of
cosmetic issues. The scar is an important factor in the patient's satisfaction.
Conventional teaching has an emphasis on the closure of skin incision with
"separate" sutures. The aim of this study was to reconsider this dogma.
Methods: Among 321 patients with acute
appendicitis who came to the emergency unit of Imam Khomeini Hospital in
Tehran, Iran since april 2007
till april 2008, 278 (86.6%) patients had
uncomplicated appendicitis and were enrolled in our clinical trial. The
patients were randomly assigned to two groups of interrupted suture closure (n=139) and subcuticular
suture closure (n=139). Anesthesia method and
surgical technique were similar between the two groups. All patients were
followed up post-operatively (four weeks) for the presence of infectious
drainage, pain, erythema, swelling and warmness at the surgical site.
Results: The patients' sex and
their mean age were not statistically different between the groups. There was
no significant difference in the frequency of surgical site complications between
the two groups (five cases in the "interrupted" group and eight cases in the
"subcuticular" group p=0.415).
Conclusion: This study showed that
appendectomy incision closure with subcuticular sutures did not increase the
risk of wound complications. From the point of better cosmetic outcome of
subcuticular sutures, this method may be the method of choice for the closure
of appendectomy incisions in uncomplicated appendicitis.
Faramarz Karimian , Hamid Ghaderi , Ali Aminian , Seyed Masoud Haghighikian , Seyedeh Adeleh Mirjafari ,
Volume 71, Issue 11 (February 2014)
Abstract
Background: Traumatic amputation of upper limb above the level of the elbow, are rare injuries that a surgeon may be faced with a handful of cases during his career. Even with advanced techniques in microvascular surgery, the survival of the transplanted limb that cut off completely from the arm is relatively weak.
Case Presentation: Four injured people (patient) in Imam Khomeini Hospital during 1999-2013 in Tehran University of Medical Sciences were treated. Two patients had complete amputation of limb and other patients suffered from complete cutting in artery and vein along with neurological and soft tissue damages. There was not any ischemia or gangrene. However, efficiency of limbs with damages in peripheral nerves was not significant. The main reason was lack of immediate repair of the damaged nerves. In the recent examination, after discharge, the performance of the limb is firstly related to the conditions of the nerve system and secondly it depends on the severity of the injury in each of the muscles. However, none of the patients were dissatisfied of any situation and they were prepared to make any cooperation for improving the condition of their transplanted limb.
Conclusion: Transplantation of the amputated limb can be done in spite of limited resources. Any delay in repairing damaged nerves will result great reduction of final organs’ performance. A limb, made from the own body, always take precedence to prosthesis, even when the efficiency is low.
Seyed Masoud Majidi Tehrani, Hamid Ghaderi , Mahnoosh Foroughi , Manouchehr Hekmat, Mahmoud Beheshti Monfared, Hassan Tatari , Seyed Mohsen Mirhosseini , Zargham Hossein Ahmadi, Zahra Ansari Aval, Seyedeh Adeleh Mirjafari,
Volume 72, Issue 2 (May 2014)
Abstract
Background: Primary cardiac tumors are rare tumors which should be operated urgently. In this study, cardiac myxoma have been evaluated from diagnosis until dis-charge in a 10 years period and then results including presenting symptoms, approach to the patients were compared with similar study in this center a decade ago.
Methods: Patients who underwent operation for myxoma from year 2003 until 2013 in the Shahid Modarres Hospital were included in this study.
Results: Eighteen patients included in the study, 11 female and seven male. Patients’ ages were in the range of 13 to 76 years (mean 53 years). Mean time from diagnosis to operation was 5.8 days and mean time from surgery to discharge was 8.6±6.1 days. Most common presenting symptoms were first clinical presentation in four patients. In all patents echocardiography was the main diagnostic modality. In addition to trans thoracic echocardiography (TTE), in five patients TEE was used and in 13 patients coronary angiography was used to rule out concomitant coronary artery disease. 94.4% of all tumors (17 cases) were primary cardiac tumors and only one tumor (5.6%) was recurrent. In 16 patients (88.9%) tumor were found in the Left Atrium (L.A) and in one case, tumor was found in both atria and in another case, tumor was in the ventricle. After tumor excision, atrial septum was repaired primarily in seven cases (38.9%) and with pericardial patch in 9 cases. One patient underwent concomitant coronary artery bypass graft (CABG) and another patient underwent concomitant pulmonary valve repair. 14 patients (77.8%) discharged from hospital without any post operative complication. Heart block occurred in one patient and cerebral emboli with secondary cerebrovascular accident (CVA) developed in two patients. One patient died (5.6%).
Conclusion: Comparing results from two similar studies in two consecutive decades revealed that mean time from diagnosis to operation obviously was reduced but ad-vances in diagnostic modalities were unable to change clinical presentation or reduce age of tumor diagnosis or complications or size.
Manouchehr Hekmat , Hamid Ghaderi , Seyedeh Adeleh Mirjafari , Shahram Rajaei Behbahani , Mehran Shahzamani , Gholamreza Masoumi ,
Volume 75, Issue 9 (December 2017)
Abstract
Background: Tetralogy of Fallot (TOF) refers to a condition in which left ventricular volume is normal or slightly less than normal. Given the differences observed in some Asian patients with TOF, the present study was conducted to investigate left heart by determining Z-scores for the mitral valve in Iranian patients with TOF.
Methods: Eligible subjects in this prospective descriptive study comprised all patients with TOF presenting to Shahid Modarres Hospital in Tehran from March 2012 to March 2015 and diagnosed as the candidates for surgery. After determining the need for surgery and the therapeutic method required, the mitral valve size and Z-scores were calculated. We analyzed sex, age, body surface area (BSA), mitral size (in 2-chamber and 4-chamber view), mitral Z-score, other cardiac anomalies, number of surgery and previous surgery.
Results: Of a total of 80 patients included in the study over 3 years, 29 (36.3%) were male and 51 (63.8%) were female. The mean age of the patients was 7.15±3.37 years and their mitral size was found to be 10-27 mm (16.2±5.99 mm) using echocardiography. Z-scores of the mitral valve were also obtained as -3.09±2.11, ranging between -7.1 SD and +1.3 SD. 58 (72.5%) patients have only TOF and 22 (27.5%) with other cardiac anomalies. 45 patients were for first time underwent surgery and 22 patients for second time, 12 patients for three time and 1 for forth. Of a total of 35 patients had previous surgery, the most common were shunt 15 (42.9%) and then tetralogy of Fallot total correction (TFTC) in 12 (34.3%). Of a total of 80 patients, 59 (73.8%) underwent TFTC, 17 (21.3%) under pulmonary valve replacement and 4 (5%) shunt.
Conclusion: Z-scores of the mitral valve were found to be significantly below the normal value, (i.e. 0±2 SD), in the study patients, suggesting the risk of hypoplastic left heart syndrome in Iranian patients with TOF, nevertheless, the type of TOF examined in these patients might have been different from those observed in other races and regions.
