Showing 6 results for Rajabi M
Shoaybi G, Soltanimohammadi S, Rajabi M,
Volume 65, Issue 2 (8 2008)
Abstract
Background: Propofol, an anesthetic noted to give rapid recovery, causes discomfort at the site of injection. A number of methods to reduce propofol-induced pain have been tried, including pretreatment with lidocaine, with varying results. Here, we evaluate the efficacy of magnesium sulfate compared to that of lidocaine and normal saline in mitigating propofol-induced pain.
Methods: One hundred ASA I and II adults, aged 20-50 years, scheduled for elective surgery requiring two IV lines with 20-gauge cannulae in the dorsum of each hand, were enrolled in this study. The patients were randomly placed into two groups of 50 patients. In each patient, one hand was the case study and other hand was the control. Group A received 10% magnesium sulfate in one hand and normal saline in the other hand. Group B received 10% magnesium sulfate in one hand and 1% lidocaine in the other hand. All injections had a volume of 2 ml. After 30 seconds, 2 cc of 1% propofol was injected simultaneously into each hand. Pain was assessed according to the VAS rating system, ranging from 0 (no pain) to 10 (the most severe pain), with a minimum interval of 3 as significant pain. Data were analyzed by chi-square and independent t tests. A P value <0.05 was considered significant.
Results: In Group A, the mean pain in the hand premedicated with magnesium was 1.46±1.07, compared to 4.54±2.15 for that of the other hand that had received normal saline (P=0.001). In group B, the mean pain in the hand that had received magnesium was 0.82±1.34, compared to 0.78±1.07 for that of the other hand, which had received lidocaine (P=0.86).
Conclusion: Intravenous magnesium and lidocaine pretreatments are equally effective in attenuating propofol-induced pain, and were better than normal saline in attenuating propofol-induced pain.
Abdollahi A, Bagheri R, Maddah Gh, Rajabi Mashhadi Mt,
Volume 66, Issue 6 (5 2008)
Abstract
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Background: Stromal tumors of the gastrointestinal tract (GISTs) are uncommon and
the cell of origin is actually mesenchymal. Stemming from smooth muscle, 90% of GISTs, or
leiomyomas, are found in the lower two thirds of the esophagus. Typically
solitary, multiple tumors (leiomyomatosis) are occasionally reported. Remaining
intramural during their growth, most of their bulk protrudes toward the
esophageal outer wall, with a freely-movable, normal-looking overlying mucosa. In
this study, we report a rare case of esophageal leiomyomatosis treated by
esophagectomy.
Case
Report: A 70-year-old man presented with discomfort upon
swallowing, dysphagia, nausea, belching and weight loss. After a barium
swallow, only dilatation of the esophagus from the retained food and saliva was
seen. CT
scan revealed a 10-cm
dilatation of the thoracic esophagus. An endoscopy and upper GI series was performed,
but no pathology was found. Esophageal manometry and pH monitoring for
gastroesophageal reflux were normal. Upon endoscopic ultrasonography, a thickening
of the esophageal wall was identified 20-30 cm from the dental arch. The patient was diagnosed with
a GIST,
referred to surgeon and a transhiatal esophagectomy was performed. The patient was
discharged from the hospital in good condition and has had no problem during
the one-year period of follow up.
Bagheri R, Tavassoli A, Sadrizadh A, Rajabi Mashhadi M, Shahri F,
Volume 66, Issue 9 (5 2008)
Abstract
Background: Penetrating thoracoabdominal stab wounds may cause diaphragmatic and abdominal organ laceration. However, 15-20% of these cases who are stable and managed by conservative treatment might have hidden diaphragmatic injuries, which could ultimately lead to chronic diaphragmatic hernia. Therefore, a safe and exact diagnostic method for the detection of occult diaphragmatic injuries is very valuable. In this study we have assessed the diagnostic value of thoracoscopy in occult diaphragmatic injuries resulting from penetrating thoracoabdominal stab wounds.
Methods: From March 2005 to October 2007, 30 hemodynamically stable patients with penetrating thoracoabdominal injuries, not requiring emergent exploration, were enrolled in this study. All subjects underwent thoracoscopy to evaluate probable diaphragmatic injury. Diaphragmatic injuries were repaired via thoracoscopy or laparatomy. All patients were evaluated for chronic diaphragmatic hernia by CT-scan six months later.
Results: The mean patient age was 26.2 years, with a male/female ratio of 5:1. Using thoracoscopic exploration, we observed five (16.7%) hidden diaphragmatic injuries, three (9.9%) of which were repaired using the thoracoscopic approach and two (6.6%) by laparatomy. Lung parenchymal laceration was seen in two patients (6.6%), for whom the repair was performed using thoracoscopy. Intra-abdominal injury was seen in one patient (3.3%), which was repaired by laparatomy. After thoracoscopy, there were no complications or evidence of chronic diaphragmatic hernia in the chest and abdominal CT-scans performed six months later. Therefore, the diagnostic accuracy of thoracoscopy in occult diaphragmatic injuries in our study was 100%.
Conclusion: With its high degree of diagnostic accuracy, low degree of invasiveness, as well as its utility in treatment, we recommend thoracoscopy for all clinically stable patients with penetrating thoracoabdominal stab wounds.
Reza Bagheri , Seyed Ziaollah Haghi , Mohammadtaghi Rajabi Mashhadi , Alireza Tavassoli , Davoud Attaran , Saeed Akhlaghi , Neusha Barekati , Maryam Esmaeeli ,
Volume 71, Issue 9 (December 2013)
Abstract
Background: Acquired paralysis of the diaphragm is a condition caused by trauma, surgical injuries, (lung cancer surgery, esophageal surgery, cardiac surgery, thoracic surgery), and is sometimes of an unknown etiology. It can lead to dyspnea and can affect ventilatory function and patients activity. Diaphragmatic plication is a treatment method which decreases inconsistent function of diaphragm. The aim of this study is to evaluate the outcome of diaphragmatic plication in patients with acquired unilateral non-malignant diaphragmatic paralysis. Methods: From 1991 to 2011, 20 patients with acquired unilateral diaphragmatic paralysis who underwent surgery enrolled in our study in Ghaem Hospital Mashhad University of Medical Science. Patients were evaluated in terms of age, sex, BMI, clinical symptoms, dyspnea score (DS), etiology of paralysis, diagnostic methods, respiratory function tests and complication of surgery. Some tests including dyspnea score were carried out again six months after surgery. We evaluated patients with SPSS version 11.5 and Paired t-test or nonparametric equivalent. Results: Twenty patients enrolled in our study. 14 were male and 6 were female. The mean age was 58 years and the average time interval between diagnosis to surgical treatment was 38.3 months. Acquired diaphragmatic paralysis was mostly caused by trauma (in 11 patients) and almost occurred on the left side (in 15 patients). Diagnostic methods included chest x-ray, CT scan, ultrasonography and sniff. Test prior to surgery the average FVC was 41.4±7 percent and the average FEV1 was 52.4±6 percent and after surgery they were 80.1±8.6 percent and 74.4±1 percent respectively. The average increase in FEV1 and FVC 63.4±4, 61.1±7.8. Performing surgery also leads to a noticeable improvement in dyspnea score in our study. Conclusion: In patients with acquired unilateral non-malignant diaphragm paralysis diaphragmatic plication is highly recommended due to the remarkable improvement in respiratory function tests and dyspnea score without mortality and acceptable morbidity.
Behzad Nazemroaya, Mehrdad Masoudifar , Motahare Rajabi Moghadam ,
Volume 79, Issue 5 (August 2021)
Abstract
Background: One of the most empirical subjects particularly in substantial operations for example in surgeries involving the vertebral column, are the implication of sedatives in a manner which would create the least complications such as changes in the hemodynamic parameters. Two such drugs that are widely used in this capacity in clinical settings are midazolam and dexmedetomidine. Hemodynamic stability is particularly important in surgical operations, especially during spinal surgery. One of the ways to prevent hemodynamic changes during surgery is the use of drugs such as midazolam and dexmedetomidine.
Methods: This double-blind randomized clinical trial recruited 105 patients undergoing laminectomy spinal surgery under spinal anesthesia at Al-Zahra Hospital, Isfahan between 21 April 2019 till 1 September 2019. Patients were randomly divided into 3 groups: First was the midazolam group, second the dexmedetomidine group and the third was the control group. Data were presented as mean±standard deviation and percentages. In order for the evaluation of differences to be performed between all groups, an evaluation using the one-way analysis of variance was utilized. Statistical analysis was done by means of the SPSS software version 23 (IBM Corporation, Armonk, New York, USA). The P-value which was accepted as significant was P less than 0.05. (P<0.05)
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Results: There differences in age and gender were not statistically significant among the studied groups (p>0.05). Results from the ANOVA test showed that the effects when taking into consideration time (P<0.001) and group (P<0.001) were statistically significant on Mean of Arterial Pressure, Systole Blood Pressure and Diastole Blood Pressure. However, Heart Rate and oxygen saturation (SPO2) were not significantly different inter-group as well as intra-group over time (before, during, and after the operation) (P=0.12). Furthermore, the mean of the hemorrhage amount and duration of recovery stay had significant differences over time between all three groups (P<0.05).
Conclusion: The incidence of complications during surgery in the dexmedetomidine group was less than the midazolam group. Additionally, the frequency of complications in the subjects given midazolam was higher than the dexmedetomidine group during recovery.
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Leila Pourali, Atiyeh Vatanchi , Arezoo Sedaghati, Farnaz Hadavi , Mohammad Taghi Rajabi Mashhadi,
Volume 79, Issue 12 (March 2022)
Abstract
Background: Sigmoid volvulus is a rare complication in pregnancy. The clinical presentation is similar to that of non-pregnant volvulus, although the symptoms can be masked by the enlarged uterus and physiological changes during pregnancy and it can be challenged and delayed in diagnosis and treatment. Delay in diagnosis can also lead to ischemia, necrosis and perforation of the intestine, which can have adverse maternal and fetal outcomes.
Case Presentation: A primigravid woman with gestational age of 31 weeks was admitted to a 3rd level center with abdominal pain and abdominal distention. From the beginning of pregnancy, the patient complained of bloating and epigastric pain, And had used herbal medicine for defecation. The patient's constipation had worsened since six days before admission to the hospital. She had no vomiting and her general condition was good. Abdominal Supine X-rays were reported completely dilated sigmoid and she was treated with a possible diagnosis of ileus. Due to the progression of symptoms and abdominal distension, rectosigmoidoscopy was performed for her, and scattered mucosal erythema was seen. Discoloration of the purple mucosa was seen from a distance of about 35 cm from the annulus and the secretions inside the sigmoid lumen were seen as blood. Ischemic necrosis and sigmoid volvulus were strongly suggested for the patient and she was immediately transferred to the operating room. The abdomen was opened with a midline incision. A 30 weeks uterus was seen and sigmoid volvulus was confirmed. Detorsion and colostomy were done. Due to the unprepared intestine and the possibility of leakage from the site of anastomosis, sigmoidectomy was not performed. After 4 days, the patient was discharged in a good general condition and became a candidate for sigmoid colon resection after delivery.
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Conclusion: All abdominal signs and symptoms during pregnancy, especially in late pregnancy have a complex interpretation and management, due to the impossibility of accurate abdominal examination. The most important factors in the proper management of sigmoid volvulus in pregnancy are fast diagnosis and treatment, hydration and antibiotic therapy.
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