Tehran University Medical Journal

Background: Neck mass is one of the most common clinical findings in all age groups. Differential diagnosis of masses includes a range of pathologies from congenital to infectious or neoplasm. Understanding the risk factors of neck masses can help us to assess them properly. The purpose of this study is to obtain the epidemiological and clinical features of different neck masses in Kerman, Iran.
Methods: This research was a descriptive, retrospective and cross-sectional study. 120 Patients that have been biopsied from neck masses during March 2014 to March 2018  in the otorhinolaryngology department of Shafa hospital of Kerman (referral center of otorhinolaryngology disease of southeastern Iran), were the participants of the study. Data regarding age, sex, history of addiction, smoking and definite pathologic diagnosis were collected and analyzed with SPSS 20^th version.
Results: Of 120 cases, 57.5 % were male and 42.5% were female. In the malignant masses group, the male to female ratio was 4.1 to 1. The average age of patients was 39.44 years old. From them, 20.83 percent had a history of smoking but 79.17 percent had never experienced smoking. In addition, 77.5% of the patients have not experienced opium consumption and 22.5% were addicted to opium regularly. There was a significant relationship between smoking and opium consumption and the incidence of malignant cervical masses (P<0.05). In the pathological study, inflammatory and infectious masses with 48.33 percent were in the head of pathology; malignant neoplasm with 25 percent, benign neoplasms with a prevalence of 12.5 percent and congenital masses with a prevalence of 9.7 percent were in the next ranks.

Methods: This was a cross-sectional study. In this study, in a period of three years from (March 2016 to March 2019), all patients admitted to the PICU of Tehran Bahrami Children's Hospital were examined. The sample size was calculated 380. Demographic information, diagnosis during hospitalization, underlying disease, and initial tests during the first 24 hours of hospitalization were recorded in the checklist. To evaluate the demographic findings between patients with and without UGIB, chi-square and Fisher tests were used. A p-value of less than 0.05 was considered significant. Results: 462 patients were studied, of which about (58%) were male. The mean age of the samples was 48 months and the average length of hospital stay in PICU was ten days. In general, (21.21%) of patients had gastrointestinal bleeding on the first day and (12.12%) on the second day of hospitalization. Gastrointestinal bleeding occurred in 50 patients (10.82%). Use of ventilator, pulmonary diseases, coagulation and blood diseases were significantly more common in patients with gastrointestinal bleeding than in children without gastrointestinal bleeding. Cardiac, neurological, hepatic, and renal disease were not significantly different in patients with gastrointestinal bleeding compared to children without gastrointestinal bleeding. Conclusion: The occurrence of gastrointestinal bleeding in critically ill patients admitted to the PICU is a serious risk. The most important risk factor for upper gastrointestinal bleeding is mechanical ventilation. Other risk factors of gastrointestinal bleeding are lung disease, coagulation diseases, hematologic and oncologic disease.

Background: Due to the prevalence of laparoscopic cholecystectomy, controlling common problems after this surgery is essential. This study aimed to determine the factors affecting pain after laparoscopic cholecystectomy.
Methods: In this cross-sectional study, 222 patients over 18 years old with symptomatic gallstones who underwent laparoscopic cholecystectomy from March 2021 to February 2022 in Mashhad Medical Sciences of Islamic Azad University Hospitals, were included. The amount of analgesic received after surgery was the same for all patients (Acetaminophen 1 gram intravenously every 8 hours and diclofenac 100 mg rectal every 8 hours). Demographic information of patients, body mass index, history of abdominal surgery, duration of surgery, carbon dioxide pressure, type of surgery (elective or emergency), number of surgical incisions, and pain intensity six and 24 hours after surgery (using a visual analog scale) were collected, and finally, the findings were statistically analyzed by SPSS version 26.

Results: Out of 222 patients, 179 cases were women (80.6%), and their average age and body mass index were 44.68±12.27 years and 27.08±4.7 kg/m2, respectively. In our study, 110 people (49.5%) had a history of abdominal surgery, of which cesarean section was the most common delete. Pain six and 24 hours after the operation was more common in women than in men, and surgery with three incisions was more painful than surgery with four incisions (P<0.05). In patients with a history of surgery, the pain was greater in six hours after surgery (P<0.05). Pain 24 hours after the operation in patients with gas pressure less than or equal to 14mmHg was greater than in patients with gas pressure greater than 14 mmHg (P<0.05). Pain six and 24 hours after surgery according to age, body mass index, type of surgery (emergency or elective), and duration of surgery had no statistically significant difference (P>0.05). Conclusion: In our study, female gender, use of three incisions for surgery, and history of previous surgery were associated with more pain after laparoscopic cholecystectomy.

Background: The aim of this study was to identify the associated risk factors of premature rupture of membranes (PROM) and preterm premature rupture of membranes (PPROM).
Methods: This retrospective case-control study was conducted at Firooz-abadi Hospital between 2019 and 2021. The study included 90 pregnant women diagnosed with PROM or PPROM (case group), compared with 90 women without this complication (control group) who presented to the hospital during the specified period. Demographic and clinical information of the case group was collected and compared with data from 90 pregnant women in the control group, matched for gestational age and other relevant factors. Statistical analysis was performed to assess the differences between the groups.

Results: Maternal age and weight were found to be significantly lower in the case group compared to the control group (P=0.02, P<0.001, respectively). This suggests that younger age and lower maternal weight may be risk factors for PROM and PPROM. Furthermore, the number of women with a history of PROM or PPROM was significantly higher in the Case group (P<0.001), indicating that a previous occurrence of membrane rupture increases the risk of subsequent incident. In addition, the study findings showed a significantly higher rate of smoking among pregnant women in the case group compared to the control group (P=0.04). Moreover, the occurrence of urinary tract infections during pregnancy and chorioamnionitis was significantly higher in the case group (P<0.001), suggesting that these infections may contribute to membrane rupture. Conclusion: In conclusion, our study provides valuable insights into the risk factors associated with PROM and PPROM. It highlights that lower maternal age and weight, a history of PROM or PPROM, lower gestational age, a history of gestational diabetes mellitus and first-trimester bleeding, smoking, and urinary tract infections during pregnancy are significantly associated with an increased risk of PROM and PPROM. These findings emphasize the importance of early identification and management of these risk factors in order to prevent or mitigate the occurrence of PROM and PPROM, ultimately improving maternal and neonatal outcomes. Further research and public health initiatives are warranted to raise awareness and promote preventive measures targeting these identified risk factors.