Showing 10 results for Tavassoli
A Tavassoli , M Rafieei ,
Volume 55, Issue 6 (1 1997)
Abstract
Hypertension is one of the most important modifiable risk factors of vascular heart disease. Control of hypertension in different age groups has a significant effect upon the control and prevention of vascular heart disease. A familial pattern is observed in the distribution of blood pressure in different societies. Family history of hypertension has a profound effect on the future risk of developing hypertension. The blood pressure of approximately 8150 inhabitants of Isfahan aged above 18 years was measured during 1993-94. Blood pressure measurements were performed according to the standards set by WHO i.e., on two separate occasions, in the sitting position, and from both arms. A questionnaire was completed consisting of 26 questions, including questions regarding history of hypertension in first and second-degree relatives. Cases with a blood pressure of 140/90 mmHg or more, were referred to the Cardiovascular Research Center of Isfahan for further evaluation. Mean systolic and diastolic blood pressure was higher in cases with a positive family history of hypertension. In this study, 37.4% of the men with hypertension and 45.4% of hypertensive women had positive history of hypertension in first-degree relatives. The association between positive family history and hypertension was not significant in men (P=0.62), but it was significant in women (P=0.000). This difference was less pronounced in the older age groups, which could be explained by the illiteracy of most of the older cases and their ignorance of the existence of hypertension in family members. After correcting for the effects of confounding factors, it appears that positive family history has a stronger association with the development of hypertension in women. Moreover, positive family history is a strong prognostic factor in the likelihood of hypertension in the children of affected cases. These findings emphasize the importance of routine blood pressure measurement in children and adolescents.
Bamdad Mehrbany K, Akbarian M, Salesi M, Geflati Z, Tavassoli S,
Volume 66, Issue 6 (5 2008)
Abstract
Background: The components of the classical complement pathway play an important role in the pathogenesis of systemic lupus erythematosus (SLE) and are reportedly useful biomarkers of disease activity. In this study, we evaluate disease activity, complement function (total hemolytic complement, CH50) and complement protein levels (C3, C4, C3d, C4d, SC5b-9), comparing the results of patients with active disease versus those with inactive disease.
Methods: This cross-sectional study included 78 hospitalized women with SLE, 24 of whom were in the active group, with SLE disease activity indexes (SLEDAI.2K) of >6, and 54 in the inactive group, with SLEDAI.2K of ≤6. Serum CH50 was measured using a red blood cell hemolytic assay. C3 and C4 levels were determined by nephlometry and plasma levels of C3d, C4d, SC5b-9 by ELISA. The data were statistically analyzed using SPSS.
Results: The mean (±standard error) C4d levels of the inactive group were significantly higher than those of the active group (23.39±1.1µg/ml and 16.9±1.6µg/ml, respectively p=0.003). There was also a significant correlation between C3 and C4 levels (p=0.807). The mean values of the other proteins (C3, C4, CH50, SC5b-9, and C3d circulating immune complex concentrations) were not significantly different between the inactive group vs. the active group: 89.35±6.8 vs. 85.54±7.6mg/dl, 18.33±2.3 vs. 20.45±2.4mg/dl, 149.03±4.3 vs. 157±4.3U, 1414.4±114.94 vs. 1471.1±216.9ng/ml, 9.43±0.96 vs. 13.31±3.16µgEq/ml, respectively (p>0.05).
Conclusions: According to our results, C4d levels may be used as a biomarker of disease activity. The significant correlation between C3 and C4 may confirm the activity of the classical pathway in SLE patients.
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.
Abdollahi A, Maddah Gh, Tavassoli A,
Volume 66, Issue 10 (4 2009)
Abstract
Background: Chronic pancreatitis is a progressive fibrosis of the pancreas that leads to loss of endocrine and exocrine function of pancreas. The most common symptom is intractable pain. Which adversely effects quality of life, remains the most common indication for surgery in patients with chronic pancreatitis.
Case report: Three patients underwent operations for chronic pancreatitis at the Ghaem hospital, Mashhad University of Medical Sciences Mashhad, Iran. Indication for operation in all cases were intractable abdominal pain. In all of the three patients complete relief of symptoms was obtained. There was no morbidity and mortality. In one patient exocrine function of pancreas and malabsorpation resolved after surgery.
Conclusions: Although chronic pancreatitis is uncommon, but in persistent abdominal pain surgery should be considered. Surgery for patients with chronic pancreatitis can be performed safely with minimal morbidity and effective in control of pain and malabsorption.
Tavassoli A, Ghamari Mj, Esmaily H,
Volume 68, Issue 3 (5 2010)
Abstract
Background: The inguinal hernia is a common disorder in general surgery. Different
methods have been described for repair of these hernias. In modern methods, synthetic mesh is used to cover the wall defect and the most known method is Lichtenstein surgical repair. The laparoscopic totally extra peritoneal procedure (TEP) is a newer technique of repairing hernia. The aim of this study is to compare the outcomes of totally extraperitoneal laparoscopic inguinal hernia repair versus Lichtenstein open repair in patients with inguinal hernia.
Methods: Among 50 patients, 25 cases underwent Lichtenstein procedure and 25 patients underwent TEP technique for repairing primary unilateral inguinal hernia. Findings during the operation have been recorded and the 12-months follow-up of patients in different views was performed through a questionnaire and then the results were compared.
Results: The operation duration, the rate of complications and frequency of recurrence were similar in two groups but the hospital stay, postoperative pain, chronic groin pain and the required time to return to normal activity were significantly lower in patients who underwent the TEP method compared to the patients who underwent the Lichtenstein technique (p<0.001, p<0.001, p=0.012, p<0.001, respectively).
Conclusion: The TEP surgical technique can be recognized as a safe method with acceptable results for patients and has significant effects on improvement of patients’ quality of life after hernia repair. Suitable results of this surgical method are achieved when the surgeon goes through the learning curve.
Tavassoli A, Abdollahi A, Golmohammadzadeh H,
Volume 70, Issue 5 (5 2012)
Abstract
Background: Regarding the limited number of studies on the feasibility of resection and repair of the small intestine by ligasure, we performed this study to compare ligasure with linear stapler for the previously mentioned operation.
Methods: This phase 1 clinical trial study was performed in Ghaem Hospital, an educational hospital affiliated to Mashhad University of Medical Sciences, from 2010 to 2011. After obtaining permission from the University's ethics committee and a written informed consent from each patient, we recruited 18 patients. The participants who had morbid obesity and were candidates for laparoscopic gastric bypass surgery were randomly allocated to two stapler and ligasure groups. The data were collected and analyzed by three statistical tests, including Mann-Whitney U test, by SPSS 16.
Results: All patients were female with the age range of 20-65 years. Cost in the stapler group ranged between 29,500,000 to 40,000,000 Rial (mean 31,830,000± 3,500,000 Rials) and in ligasure group it was between 24,000,000 to 35,000,000 Rials (mean 26,720,000± 3,290,000 Rials). There was a significant difference between the two groups in cost (P=0.004(. Duration of the operations were 200±3.4 and 240±10 minutes in the stapler and ligasure groups, respectively. The difference in duration was significant between the two groups (P=0.043). No significant differences were observed in complications.
Conclusion: Application of ligasure in resection and reconstruction of small intestine is more cost-effective than stapler, although duration of surgery is longer.
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.
Ghodratolah Maddah , Hossein Shabahang , Mohammad Reza Barband , Abbas Abdollahi , Alireza Tavassoli ,
Volume 72, Issue 9 (December 2014)
Abstract
Background: This study aims to evaluate the outcomes and late complications of open Roux-en-Y gastric bypass surgery in the treatment of morbid obesity.
Methods: Over a 15 year-period between May 1997 and May 2012, we reviewed our experiments with 39 patients who underwent open gastric bypass for morbid obesity. The weight of the patient and surgical complications were recorded. Ideal weight, body mass index, weight loss and excess weight loss were calculated.
Results: The follow up period ranged from 6 to 180 months with a mean of 100 months after operation. Average weight loss was 3.9 and 0.28 kg per month during the first and second years after operation weight loss was slower from the third year on-wards. Weight loss generally was stabilized between 12 and 18 months after operation. Only one patient (2.6%) had a weight loss failure criterion. Concomitant condition ex-isted in 14 patients (48.2%) of our series. These included hypertension in 3 cases (10.3%) that was resolved in 100%, diabetes mellitus in 4 (13.7%) that was resolved in 75%, cholelithiasis in 7 cases (24.1%) that was resolved by cholecystectomy during the operation. There was no early postoperative death. Early complications occurred in 2 patients (5.1%), including pulmonary embolism (2.6%) and gastrointestinal bleeding (2.6%). The late complications occurred in 7 patients (17.9%) involved 2 patients with anastomotic stricture at the gastrojejunostomy (5.1%), One patient with symptomatic cholelithiasis (2.6%), three patient with anemia (7.7%), and one patient had Wernicke ’s disease who died of this complication (2.6%).
Conclusion: The results of the study showed that the open Roux-en-Y gastric bypass surgery is an effective procedure in the treatment of morbid obesity with minimal late complications.
Alireza Tavassoli , Sadjad Noorshafiee , Ahmadreza Tavassoli , Saeedeh Hajebi Khaniki ,
Volume 75, Issue 12 (March 2018)
Abstract
Background: The benefits of aspirin have been proven by repeated examinations, especially in secondary prevention in cardiac infarction, stroke, and after interventional angiography and stent insertion.
Methods: This is a retrospective study on all patients who underwent non-cardiac surgeries between June 2005 and March 2013 in Ghaem hospital in Mashhad and aspirin continued due to many reasons. Most frequent surgeries included laparoscopic appendectomy and cholecystectomy. Information such as bleeding and its amount both during surgery and post-operative, hematoma after surgery, requiring re-operation due to bleeding and cardiovascular events in hospital were recorded and analyzed. Moreover, all patients were followed within one month after discharge from hospital to check whether any cardiovascular events had been happened. Furthermore, bruising in the skin, and bleeding after discharge were evaluated. Data were analyzed using SPSS Version 16 (SPSS, Chicago, IL, USA).
Results: One hundred seventy patients enrolled in the study and all of them underwent general anesthesia. Of all patients 37.06% were male and 62.94% were female. The mean age was 52.78±5.01 years. Majority of operations included laparoscopic cholecystectomy (41.62%). Also in most of the patients (58.38%) surgery were emergency and discontinuation of aspirin were impossible. 91.37% of patients were taking less than 80 mg aspirin per day. Mean bleeding amount during surgery was 100 ml. 13 patients (6.59%) who undergo laparoscopic cholecystectomy and one patients in appendectomy group had bleeding more than 110 ml due to inadequate artery ligation and they underwent conversion to open surgery and bleeding were controlled successfully. Other eight patients (4.06%) treated conservatively without need to conversion to open surgery. In 7.61% of patients, ecchymosis happened which were healed within one month. No patient underwent reoperation due to post-operative hemorrhage. No vascular event and hematoma had been reported during one month follow up after surgery.
Conclusion: Continuing aspirin in perioperative period of non-cardiac surgeries were without additional risk of bleeding and it also helped to reduce risk of vascular evets post-operatively.
Seyed Hassan Seyed Sharifi , Alireza Tavassoli, Mohammad Etezadpour,
Volume 80, Issue 1 (April 2022)
Abstract
Background: Hemorrhoids are one of the most common perianal diseases. They have several surgical and non-surgical treatment methods. Among surgical procedures, Stapler hemorrhoidopexy method has recently gained widespread acceptance. Hemorrhoidopexy with a circular stapler usually has a series of common and mild complications and a few rare and life-threatening complications such as rectal perforation, which requires emergency surgery. In this article, a case of rectal perforation in a middle-aged man following hemorrhoidopexy with Circular Stapler in a Procedure for Prolapse and Hemorrhoids (PPH) is reported that he underwent emergency surgery.
Case Presentation: The patient is a 43-year-old man who presented to the emergency department of Mashhad Ghaem Hospital in June 2020 due to acute general abdominal pain especially in the lower abdomen that started 3 days ago the patient has a history of hemorrhoidopexy with a Circular Stapler in a Procedure for Prolapse and Hemorrhoids (PPH) 5 days ago. The patient had a fever at the time of referral, other vital signs were normal. During the examination, the patient had tenderness and rebound tenderness, especially in the lower abdomen. Hydropneumoperitoneum or Retropneumoperitoneum or Hydroretropneumoperitoneum was reported on the abdomen and pelvic Computed Tomography (CT) scan with and without oral and intravenous contrast. The patient was diagnosed with intraperitoneal rectal perforation. He was then diagnosed with intraperitoneal rectal perforation and treated with intravenous antibiotics and surgery. After surgery, the patient's general condition improved and he was discharged without mortality and morbidity with the good condition after 6 days.
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Conclusion: Hemorrhoidopexy with a stapler is more widely accepted than other hemorrhoidectomy methods especially manual methods for prolapse hemorrhoids due to less postoperative pain, shorter hospital stays, and faster return to work. Although this procedure usually has mild side effects that do not require surgery, sometimes life-threatening complications such as rectal perforation may happen, which requires prompt diagnosis and appropriate treatment.
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