30 research outputs found
Effect of lidocaine jelly on the post tonsillectomy complications
Background and aim: Laryngospasm, laryngitis and bleeding are the most serious complications after tonsillectomy. In this study, the frequency of these complications and their correlation with age, sex and application of lidocaine jelly has been assessed. Method: The sample consisted of 100 patients aged from 5 to15 years undergoing tonsillectomy in Resalat hospital of Shahrekord, during 6 months. The subjects were divided randomly into two groups. Case group intubated with 2% lidocaine gel via the endotracheal tube, and control group intubated without lidocaine gel. Laryngospasm, laryngitis and bleeding were recorded during the first postoperative day. Results: The incidence of laryngospasm and laryngitis was 8% and 17% respectively. There were no correlations between these problems and age or sex. The incidence of bleeding was 16% that was higher in older and female patients. The endotracheal tube lubrication with 2% lidocaine gel attenuated laryngospasm during recovery after tonsillectomy in children but it was not effective on laryngitis and bleeding. Conclusion: The application of lidocaine gelly after tonsilectomy for prevention of laryngospasm is recomended
A comparative study on the structure of English abstracts of Persian and English medical journals
زمینه و هدف: امروزه مقاله نویسی علمی اهمیت خاصی پیدا کرده است و بهترین راه به اشتراک گذاشتن دستاوردهای علمی بنظر میرسد به شرط آنکه معیارهای تعیین شده مرتبط با زبان مقاله نویسی رعایت گردد. هدف از این تحقیق شناسایی انحرافات ساختاری چکیده های ترجمه انگلیسی چاپ شده در مجلات فارسی زبان ایرانی و مقایسه آنها با چکیده هایی است که از ابتدا به زبان انگلیسی نوشته شده و در مجلات بین المللی پزشکی به چاپ رسیده اند. روش بررسی: در این مطالعه توصیفی- تحلیلی تعداد 64 چکیده (32 چکیده از مجلات ایرانی و 32 چکیده از مجلات بین المللی) بر اساس مدل پیشنهادی Swales مورد تجزیه و تحلیل و مقایسه قرار گرفت. بررسی دقیق تری هم بر اساس مدلCARS (Create A Research Space) پیشنهاد شده توسطSwales در قسمت مقدمه این چکیده ها انجام شد. توالی مقدمه، مواد و روش ها، یافته ها و نتیجه گیری (IMRC=Introduction, Methods, Results, Conclusion) به عنوان قسمتهای ساختاری جهت بررسی در نظر گرفته شد. داده ها به کمک آزمون های آماری کای اسکوئر و آزمون دقیق فیشر تجزیه و تحلیل شد. یافته ها: یافته ها نشان داد در حالی که چکیده های ترجمه شده همگی توالی IMRC را رعایت کرده اند، در چکیده های اصیل انگلیسی زبان این توالی کاملاً رعایت نشده است. در قسمت مقدمه چکیده ها، اختلاف معنی داری در نگارش بیان هدف تحقیق وجود داشت که در چکیده های ترجمه شده بیشتر به چشم می خورد (001/0
Predicting Difficult Laryngoscopy and Intubation With Laryngoscopic Exam Test: A New Method.
Airway assessment is fundamental skill for anesthesiologists and failure to maintain a patient's airway is the tremendous cause of anesthesia-related morbidity and mortality. None of the tests which have recommended for predicting difficult intubation stands out to be the best clinical test or have high diagnostic accuracy. Our study aimed to determine the utility of a new test as "laryngoscopic exam test (LET)" in predicting difficult intubation. Three hundred and eleven patients aged 16-60 years participated and completed the study. Airway assessment was carried out with modified Mallampati test, upper lip bit test and LET preoperatively, and Cormack and Lehane's grading of laryngoscopy were assessed during intubation as a gold standard, and difficult laryngoscopy was considered as Cormack and Lehane's grade ΙΙΙ or ΙV of laryngoscopic view. The incidence of difficult intubation was 6.1%. The LET showed higher sensitivity, specificity, and accuracy (P<0.05), without revealing significant differences among three tests (P=0.375). The LET is a simple bedside test and an alternative method for predicting difficult intubation
Sensitivity, Specificity and Accuracy of Color Doppler Ultrasonography for Diagnosis of Retinal Detachment
Purpose: This study evaluated the sensitivity, specificity, and diagnostic accuracy of Color Doppler Ultrasonography (CDUS) in patients with suspected retinal detachment (RD) who underwent surgery.
Methods: In this prospective, observational clinical study, 65 eyes of 65 consecutive patients with suspected RD with opaque media were included. Following a standardized protocol, CDUS of the retina of the affected eye was performed. The sensitivity, specificity, and diagnostic accuracy of CDUS were determined and compared to the findings during surgery.
Results: The mean age of patients (18 men and 47 women) was 52.36 years (range: 8–77 years). The sensitivity, specificity, and overall accuracy of ocular CDUS were 91.3%, 88.1%, and 89.2%, respectively. The false-negative rate (negative CDUS images but presence of RD at operation) was 3.1% (2/65) and the false-positive rate (positive CDUS images but absence of RD at operation) was 7.7% (5/65).
Conclusion: CDUS of the retina could be considered as a promising tool in the diagnosis of RD in patients with opaque media
Bilateral Angle-Closure Glaucoma in a Young Female Receiving Cabergoline: A Case Report
Purpose: To report a case of bilateral acute angle-closure glaucoma after oral administration of cabergoline for the treatment of galactorrhea. Methods: A diagnosis of secondary drug-induced angle-closure glaucoma was made in a patient with elevated intraocular pressure (IOP) and myopic refractive shift, which was confirmed by ultrasound biomicroscopy (UBM) of the ciliary body and anterior segment, sonography, and optical coherence tomography. The treatment included the discontinuation of the culprit drug and the administration of topical anti-glaucoma drops. The treatment course was followed with serial measurements of the IOP and refraction, and with performing UBM. Results: Five hours after he received a single 0.5-mg oral cabergoline tablet, the patient suffered from acute secondary angle-closure glaucoma and myopic refractive error. UBM demonstrated both effusion of the ciliary body and an anterior rotation of the iris-ciliary body. IOP was reduced 8 h after cessation of the causative agent and administration of anti-glaucoma drops. Refractive errors returned to normal levels after 8 days. Conclusion: Secondary acute angle-closure glaucoma has been reported to occur after the administration of some drugs. In this report, an attempt has been made to describe this adverse reaction after oral cabergoline intake
Effect of Ramadan fasting on physiologic myopia
زمینه و هدف: نزدیک بینی از شایع ترین نوع عیوب انکساری چشم است. با توجه به اینکه تغذیه از جمله عوامل متعددی است که در ایجاد میوپی دخیل میباشد . این مطالعه با هدف بررسی میزان تاثیر روزه داری بر مقدار میوپی در طی ماه مبارک رمضان انجام شد. روش بررسی: مطالعه به صورت توصیفی – تحلیلی بر روی 122 چشم از 61 نفر انجام شد. جامعه مورد بررسی افراد میوپ مذکر با درجه نزدیک بینی 50/0- تا 00/8- دیوپتر در سنین 50-22 سال بودند. قبل از ماه مبارک رمضان کلیه افراد تحت معاینه کامل چشمی قرار گرفتند و عیب انکساری آنها با روش Cycloplegic refraction اندازه گیری شد. پس از پایان ماه مبارک رمضان در افرادی که توفیق روزه داری به مدت حداقل 29 روز را داشتند مجدداً معاینات چشمی شامل حدت بینایی و عیب انکساری و معاینه با Slit lamp و فوندوسکپی انجام شد و نتایج قبل و بعد از روزه داری با استفاده از آزمون t زوج مورد بررسی و تحلیل قرار گرفت. یافته ها: میانگین سنی بیماران 24/11±20/31 (دامنه 50-22) سال بود. حدت بینایی تمام بیماران 20/20 بود. میانگین عیب انکساری افراد قبل و پس از روزه داری به ترتیب 80/2±21/3- و 00/3±16/3- دیوپتر به دست آمد (05/0P>). نتیجه گیری: روزه داری در افراد مذکر بالای 22 سال موجب تغییر مقدار میوپی نمی شود
Towards Long-term and Archivable Reproducibility
Analysis pipelines commonly use high-level technologies that are popular when
created, but are unlikely to be readable, executable, or sustainable in the
long term. A set of criteria is introduced to address this problem:
Completeness (no execution requirement beyond a minimal Unix-like operating
system, no administrator privileges, no network connection, and storage
primarily in plain text); modular design; minimal complexity; scalability;
verifiable inputs and outputs; version control; linking analysis with
narrative; and free software. As a proof of concept, we introduce "Maneage"
(Managing data lineage), enabling cheap archiving, provenance extraction, and
peer verification that been tested in several research publications. We show
that longevity is a realistic requirement that does not sacrifice immediate or
short-term reproducibility. The caveats (with proposed solutions) are then
discussed and we conclude with the benefits for the various stakeholders. This
paper is itself written with Maneage (project commit eeff5de).Comment: The downloadable source (on arXiv) includes the full/automatic
reproduction info (scripts, config files and input data links). Supplementary
datasets and source also available on Zenodo.3872248:
https://doi.org/10.5281/zenodo.4291207 . v2: Referee points addressed, two
appendices adde
Rhegmatogenous retinal detachment: an analysis of 2315 eyes over a six-year period
Background: Rhegmatogenous retinal detachment (RRD) is a form of retinal detachment caused by passage of fluid from the vitreous cavity into the space between the neurosensory retina and the retinal pigment epithelium via a retinal break or full-thickness defect. At our tertiary referral center, we evaluated the clinical and epidemiological features of RRD, and we herein report the frequency of related risk factors.
Methods: In this retrospective study, we reviewed the records of patients with a final diagnosis of RRD at an academic ophthalmological referral center in Isfahan, Iran, over a six-year period. We retrieved and reviewed data from the medical records of all eligible participants, including sex, age, laterality, lens status, macular status, type of RRD, location and number of breaks, type of surgery, rate of re-operation during the first year after initial surgery, and documented clinical risk factors for RRD. Clinical risk factors were categorized as the presence of myopic refractive error, ocular trauma, history of cataract surgery, history of other ocular surgeries, history of uveitis, or undetermined.
Results: We included 2315 eyes of 2229 patients with a mean (standard deviation [SD]) age of 51.1 (16.9) years and a male-to-female ratio of 1.8:1. The most common quadrants containing retinal breaks were the superotemporal quadrant (34.1%), inferotemporal quadrant (23.4%), and superonasal quadrant (10.7%). Macula-involved RRD was seen in 90% of eyes (n=2083 eyes). The most frequently identified risk factors were cataract surgery (32.9%) and myopia (22.3%) in adults, and myopia (35.0%) and ocular trauma (27.4%) in the pediatric group. Most eyes underwent pars plana vitrectomy (51.3%), whereas pneumatic retinopexy (0.7%) was the least commonly selected.
Conclusions: Our results indicate that cataract surgery and myopia are the most common risk factors for RRD in adults. Myopia and ocular trauma are the most common risk factors in pediatric patients. As observed in many studies, the characteristics of the study population, including middle age, male sex, myopia, and ocular trauma, may be associated with RRD at different rates. Further population-based longitudinal studies with larger sample sizes are required to verify these preliminary observations
Lazer Navigating System: A New System for Finding and Removing Forigner Bodies
Finding Foreign Bodies (FB) inside different parts of the body have been difficult for all of the
surgeons. Although at first it seems easy to remove these FB but during operation many
problem for their removing can occurs, the most important of them is that they can not be
find. Many orthopedists, general surgeons and neurosurgeons had experienced with this
problem. In this study we are trying to show the efficacy of Lazer Navigating System (LNS) a
new system that we have designed for finding and removing FB inside different parts of ..
Global burden and strength of evidence for 88 risk factors in 204 countries and 811 subnational locations, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021
Background: Understanding the health consequences associated with exposure to risk factors is necessary to inform public health policy and practice. To systematically quantify the contributions of risk factor exposures to specific health outcomes, the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 aims to provide comprehensive estimates of exposure levels, relative health risks, and attributable burden of disease for 88 risk factors in 204 countries and territories and 811 subnational locations, from 1990 to 2021. Methods: The GBD 2021 risk factor analysis used data from 54 561 total distinct sources to produce epidemiological estimates for 88 risk factors and their associated health outcomes for a total of 631 risk–outcome pairs. Pairs were included on the basis of data-driven determination of a risk–outcome association. Age-sex-location-year-specific estimates were generated at global, regional, and national levels. Our approach followed the comparative risk assessment framework predicated on a causal web of hierarchically organised, potentially combinative, modifiable risks. Relative risks (RRs) of a given outcome occurring as a function of risk factor exposure were estimated separately for each risk–outcome pair, and summary exposure values (SEVs), representing risk-weighted exposure prevalence, and theoretical minimum risk exposure levels (TMRELs) were estimated for each risk factor. These estimates were used to calculate the population attributable fraction (PAF; ie, the proportional change in health risk that would occur if exposure to a risk factor were reduced to the TMREL). The product of PAFs and disease burden associated with a given outcome, measured in disability-adjusted life-years (DALYs), yielded measures of attributable burden (ie, the proportion of total disease burden attributable to a particular risk factor or combination of risk factors). Adjustments for mediation were applied to account for relationships involving risk factors that act indirectly on outcomes via intermediate risks. Attributable burden estimates were stratified by Socio-demographic Index (SDI) quintile and presented as counts, age-standardised rates, and rankings. To complement estimates of RR and attributable burden, newly developed burden of proof risk function (BPRF) methods were applied to yield supplementary, conservative interpretations of risk–outcome associations based on the consistency of underlying evidence, accounting for unexplained heterogeneity between input data from different studies. Estimates reported represent the mean value across 500 draws from the estimate's distribution, with 95% uncertainty intervals (UIs) calculated as the 2·5th and 97·5th percentile values across the draws. Findings: Among the specific risk factors analysed for this study, particulate matter air pollution was the leading contributor to the global disease burden in 2021, contributing 8·0% (95% UI 6·7–9·4) of total DALYs, followed by high systolic blood pressure (SBP; 7·8% [6·4–9·2]), smoking (5·7% [4·7–6·8]), low birthweight and short gestation (5·6% [4·8–6·3]), and high fasting plasma glucose (FPG; 5·4% [4·8–6·0]). For younger demographics (ie, those aged 0–4 years and 5–14 years), risks such as low birthweight and short gestation and unsafe water, sanitation, and handwashing (WaSH) were among the leading risk factors, while for older age groups, metabolic risks such as high SBP, high body-mass index (BMI), high FPG, and high LDL cholesterol had a greater impact. From 2000 to 2021, there was an observable shift in global health challenges, marked by a decline in the number of all-age DALYs broadly attributable to behavioural risks (decrease of 20·7% [13·9–27·7]) and environmental and occupational risks (decrease of 22·0% [15·5–28·8]), coupled with a 49·4% (42·3–56·9) increase in DALYs attributable to metabolic risks, all reflecting ageing populations and changing lifestyles on a global scale. Age-standardised global DALY rates attributable to high BMI and high FPG rose considerably (15·7% [9·9–21·7] for high BMI and 7·9% [3·3–12·9] for high FPG) over this period, with exposure to these risks increasing annually at rates of 1·8% (1·6–1·9) for high BMI and 1·3% (1·1–1·5) for high FPG. By contrast, the global risk-attributable burden and exposure to many other risk factors declined, notably for risks such as child growth failure and unsafe water source, with age-standardised attributable DALYs decreasing by 71·5% (64·4–78·8) for child growth failure and 66·3% (60·2–72·0) for unsafe water source. We separated risk factors into three groups according to trajectory over time: those with a decreasing attributable burden, due largely to declining risk exposure (eg, diet high in trans-fat and household air pollution) but also to proportionally smaller child and youth populations (eg, child and maternal malnutrition); those for which the burden increased moderately in spite of declining risk exposure, due largely to population ageing (eg, smoking); and those for which the burden increased considerably due to both increasing risk exposure and population ageing (eg, ambient particulate matter air pollution, high BMI, high FPG, and high SBP). Interpretation: Substantial progress has been made in reducing the global disease burden attributable to a range of risk factors, particularly those related to maternal and child health, WaSH, and household air pollution. Maintaining efforts to minimise the impact of these risk factors, especially in low SDI locations, is necessary to sustain progress. Successes in moderating the smoking-related burden by reducing risk exposure highlight the need to advance policies that reduce exposure to other leading risk factors such as ambient particulate matter air pollution and high SBP. Troubling increases in high FPG, high BMI, and other risk factors related to obesity and metabolic syndrome indicate an urgent need to identify and implement interventions