Safety Evaluation of Elderly Laparoscopic Cholecystectomy

Objectives: The most common indication for abdominal surgery in elderly (65 & older) is gallstone disease.The elderly are more prone to complication of such surgery due to their other co-morbidity and thus they may benefit mostly from a safer method of surgical procedure. The purpose of this study was to evaluate the safety and outcome of laparoscopic cholecystectomy in elderly compare to the conventional method. Methods & Materials: Via prospective study from June 2005 to March 2008 included all patient older than 60 years of age who underwent cholecystectomy by open (Group A) and laparoscopic (Group B) method in Milad Hospital.The demographic data (sex age), American Society of Anesthesiologists’ (ASA) score, postoperative mortality morbidity, length of stay and operative time were recorded for each patient and were compared between two methods. Data of patient’s analysis by SPSS with chi-square and t test. Results: The study included 311 elderlies (34% men and 66% women). Hundred fifty-seven patients underwent open cholecystectomy; 154 patients underwent laparoscopic cholecystectomy. The mean age was 7141 years. The outcome in group B (laparoscopic) included: morality 0%, morbidity 2%, postoperative hospital stay 1 days, mean operation time was 40 minutes. In group A(open): mortality and morbidity rate were 21% and 12% respectively with postoperative hospital stay 331 days and similar operation time as group A. Conclusion: Laparoscopic cholecystectomy is the gold standard treatment and safe procedure in elderly patient and aging is not considered to be a contraindication laparoscopic surgery in such patients

What is a key step in the falling process in older people? A qualitative study in an Iranian context

Falls in elderly people occur commonly and may result in significant morbidity and mortality. Prevention of falls is quite possible. The important point is to know and use interventions appropriate to each context. The aim of this study was to explore the facilitators and barriers of the process of falling in elderly people in an Iranian context. A grounded theory data analysis method (constant comparative analysis) was applied using semistructured interviews with15 older persons and seven formal and informal caregivers. According to the experiences of the participants of the current study, the main situation was “response to ageing,” and eight major concepts related to this situation have been explored. In reaction to ageing, older persons show three main responses including maladaptive, corrective adaptation, and unsuccessful or disruptive adaptation. Other related concepts include physical and mental condition, learning on aging, fall consequences, fatalism in falls, lifestyle, social factors related to falling, environmental factors, and restrictive care. Responses to ageing had the most important role in shaping the process of falls. Therefore, the type of interventions that lead people to respond appropriately to aging may be an effective factor in preventing falls in elderly people. It is also necessary to explore the process of fall in each context

Chronic Kidney Diseases, Metabolic Syndrome and Crp Level in The Elderly Residents of Kahrizak Charity Foundation

Objectives: In this study, we investigated the inter-relationships between C-reactive protein, metabolic syndrome, and chronic kidney disease among a group of Iranian elderly. Methods & Materials: In this cross-sectional study, 122 elderly among 1220 aged residents of Kahrizak Charity foundation with average age of 73.6&plusmn;9.71 were studied. Metabolic syndrome and chronic kidney diseasewere defined according to the criteria of National Cholesterol Education Program,Adult Treatment Panel III and an estimated glomerular filtration rate<60 mL/min/1.73 m2, respectively. C-reactive protein&ge;3mg/dl was considered as a high CRP. Results: Prevalence of Chronic Kidney Disease was 82.9(59.3%) in subjects with and without metabolic syndrome, respectively (P<0.006). Subjects with metabolic syndrome and high C-reactive protein had 1.71-fold greater odds of having Chronic Kidney Disease. Conclusion: Metabolic syndrome was a risk factor for chronic kidney disease in elderly people of this study. The odds of chronic kidneydisease also increased significantly in presence of high C-reactive protein and metabolic syndrome