Giant megacolon caused by anterior displacement of the anus in a 71-year-old woman

The patient was a 71-year-old woman who was referred to the general surgery clinic due to a severe colonic dilatation and a fecal mass that was found in her abdominopelvic CT scan, which was ordered by a nephrologist for approaching her right flank pain. The patient had experienced bloating and progressive abdominal distension in the year prior to the current visit. The last defecation had occurred approximately 20 days prior to the visit, and the last gas passage had occurred the day before the visit.&nbsp

Outcomes of Catheter-Directed Thrombolysis in Patients with Acute Arterial Thrombotic Limb Ischemia: A Prospective Interventional Case Series

Introduction: Acute limb ischemia is a critical medical condition that can quickly become a life threat. Therapeutic modalities such as catheter-directed thrombolysis (CDT) have demonstrated various levels of efficacy in previous studies. Objective: This study presents the descriptive findings of a series of cases who presented with acute arterial thrombotic limb ischemia and underwent CDT. Methods: This was a cross-sectional single-hospital-based case series, in which all patients who were diagnosed with acute arterial thrombotic limb ischemia, and consequently underwent CDT during the one-year study period were included.  Detailed baseline characteristics and clinical findings of the studied patients on presentation, after intervention and at one-year follow-up are presented. Results: A total of 21 patients with a mean age of 60.7±15.2 years, including 16 males (76.2%) were included. The initial technical and treatment success rates were 20 (95.2%) and 14 (66.7%), respectively. The amputation-free and the overall survival rates after the one-year follow-up were 15 (71.4%) and 17 (81%), respectively. Four patients (19%) developed complications, two (9.5%) of which were significant (pulmonary hemorrhage and intraventricular hemorrhage). Amputation was performed in 6 (28.6%) cases. Conclusion: In this study, the treatment success rate and the technical success rate were satisfactory

Management of a Penetrating Thoracic Injury with Thoracoscopy; A Case Study

Introduction: Various strategies could be considered dealing with penetrating thoracic injuries. Thoracoscopy is much less invasive than routine thoracotomy approach for managing such cases in which the sharp object remains in the body. The case presented in this article was managed with thoracoscopy for a penetrating dorsolateral thoracic injury. Case Presentation: A 35-year-old man with a penetrating dorsolateral thoracic injury referred to the emergency department. Despite an elevated pulse rate, the patient has proper blood pressure and O2 saturation. Considering the patient's stability and the results of imaging which did not show any massive vascular injury, the patient was taken to the operation room for thoracoscopy. At thoracoscopy, we saw 4 cm of the blade in the thoracic cavity between the third and fourth intercostal space. There was a mild laceration of lung tissue without any active bleeding. Considering the position of the blade and the absence of active bleeding and vascular injury at the trauma site, we successfully removed the blade by the thoracoscope without any complications. Conclusion: Our experience of removing a retained knife by thoracoscopy showed that it can be an appropriate alternative for patients with penetrating thoracic injury who are hemodynamically stable and have appropriate conditions for thoracoscopy

Management of a Penetrating Thoracic Injury with Thoracoscopy; A Case Study

Introduction: Various strategies could be considered dealing with penetrating thoracic injuries. Thoracoscopy is much less invasive than routine thoracotomy approach for managing such cases in which the sharp object remains in the body. The case presented in this article was managed with thoracoscopy for a penetrating dorsolateral thoracic injury. Case Presentation: A 35-year-old man with a penetrating dorsolateral thoracic injury referred to the emergency department. Despite an elevated pulse rate, the patient has proper blood pressure and O2 saturation. Considering the patient's stability and the results of imaging which did not show any massive vascular injury, the patient was taken to the operation room for thoracoscopy. At thoracoscopy, we saw 4 cm of the blade in the thoracic cavity between the third and fourth intercostal space. There was a mild laceration of lung tissue without any active bleeding. Considering the position of the blade and the absence of active bleeding and vascular injury at the trauma site, we successfully removed the blade by the thoracoscope without any complications. Conclusion: Our experience of removing a retained knife by thoracoscopy showed that it can be an appropriate alternative for patients with penetrating thoracic injury who are hemodynamically stable and have appropriate conditions for thoracoscopy

Risk assessment of occupational exposure to BTEX in the National Oil Distribution Company in Iran

BACKGROUND: This study evaluated the quantitative, carcinogenic and non-carcinogenic risk of exposure to BTEX using lifetime cancer risk (LCR) and hazard quotient (HQ) in the National Company for Distribution of Petroleum Products in Iran.METHODS: In this risk assessment method, the data were collected in different parts of the company. In order to determine the concentration of BTEX, sampling was carried out in different parts using activated carbon. A Gas Chromatography–Flame Ionization Detector (GC-FID) was used for analysis. Analysis and sampling was conducted according to the NIOSH 1500 method. For carcinogenic risk assessment, LCR was calculated. For non-carcinogenic risk assessment, HQ was calculated.RESULTS: The carcinogenetic risk of benzene was definite for loading and deep handling units, and safety officer, and was probable rank for sealing, inspection gate, security, loading 1, and deep handling units. The carcinogenic risk of ethylbenzene was definite for quality control and loading 1 units, was probable for deep handling and loading 2 units, and safety officer, and was possible for sealing, inspection gates, security units. The non-carcinogenic risk of toluene was acceptable for deep handling, clothing, inspection gates, and sealing units, but was unacceptable for officer safety, quality control, loading 1, and loading 2 units. The non-carcinogenic risk of xylene was acceptable for the inspection gate unit, but was unacceptable for security, sealing, officer safety, quality control, deep handling, loading 1, loading 2 units.CONCLUSIONS: This risk assessment method used was a comprehensive and quantitative method, so it determined risk accurately. Commensurate with the risk level of each part of the company, the appropriate corrective actions must be carried out

Risk assessment of occupational exposure to BTEX in the National Oil Distribution Company in Iran

BACKGROUND: This study evaluated the quantitative, carcinogenic and non-carcinogenic risk of exposure to BTEX using lifetime cancer risk (LCR) and hazard quotient (HQ) in the National Company for Distribution of Petroleum Products in Iran. METHODS: In this risk assessment method, the data were collected in different parts of the company. In order to determine the concentration of BTEX, sampling was carried out in different parts using activated carbon. A Gas Chromatography–Flame Ionization Detector (GC-FID) was used for analysis. Analysis and sampling was conducted according to the NIOSH 1500 method. For carcinogenic risk assessment, LCR was calculated. For non-carcinogenic risk assessment, HQ was calculated. RESULTS: The carcinogenetic risk of benzene was definite for loading and deep handling units, and safety officer, and was probable rank for sealing, inspection gate, security, loading 1, and deep handling units. The carcinogenic risk of ethylbenzene was definite for quality control and loading 1 units, was probable for deep handling and loading 2 units, and safety officer, and was possible for sealing, inspection gates, security units. The non-carcinogenic risk of toluene was acceptable for deep handling, clothing, inspection gates, and sealing units, but was unacceptable for officer safety, quality control, loading 1, and loading 2 units. The non-carcinogenic risk of xylene was acceptable for the inspection gate unit, but was unacceptable for security, sealing, officer safety, quality control, deep handling, loading 1, loading 2 units. CONCLUSIONS: This risk assessment method used was a comprehensive and quantitative method, so it determined risk accurately. Commensurate with the risk level of each part of the company, the appropriate corrective actions must be carried out

Primary Patency Rate of Superficial Femoral Artery Angioplasty in Patients with Stenosis/Occlusion of Femoropopliteal Artery

Background: The primary patency rate (PPR) is still controversial in angioplasty and heart bypass surgery for blood vessel repair and reconstruction in patients with femoropopliteal disease. Objectives: This study aimed to investigate the prolonged PPR rate in patients with stenosis/occlusion of the femoropopliteal artery undergoing superficial femoral artery (SFA) and popliteal angioplasty. Methods: A case series study population consisted of patients demonstrating femoropopliteal artery occlusion referred to Sina Hospital, Tehran, Iran for angiography during 2016-2018. After angiography, patients underwent either stent placement or balloon angioplasty in the case of stenosis/occlusion of femoropopliteal arteries. After angioplasty, patients were followed up in the 3rd, 12th, and 24th months for re-examination, and color Doppler ultrasonography of femoropopliteal arteries was also performed to measure the patency rate. The SPSS Statistics version 21.0 was used to analyze the data. The Kaplan–Meier method and a log-rank test were utilized to evaluate this rate. Results: Sixty patients were included in the study, from which 44 were women (73.3%) and 16 were men (26.6%) with a mean age of 69.9 years. Fifty-two, 41, and 29 patients were examined at intervals of 3, 12, 24 months, with PPRs of 86%, 79%, and 68%, respectively. There was a significant relationship between claudication degree and procedure success (P = 0.02). Conclusion: The prolonged PPR rate of patients after femoropopliteal artery angioplasty was acceptable and was a safe and effective treatment. For future studies, an increase in the number of study variables, a more comprehensive classification, and PPR-related variables are suggested

Patency rate and factors affecting the clinical outcome of patients with aortoiliac artery occlusion undergoing intra-arterial stenting

Background Occluding plaques are commonly found inthe infrarenal aorta and the iliac artery in patients with peripheralarterial disease (PAD). Aortoiliacocclusive disease(AIOD) occurs commonly in patients with PAD.Methods: This is a prospective study was carried out between2015 and 2017 in Sina hospital. Patients with occlusionin aortoiliac artery and its branches were included.Stent was placed for patients, if they had any obstructionor stenosis in aortoiliac artery in angiography. Patientswere examined in terms of clinical status and ABI calculationand underwent Color Doppler ultrasound of aortoiliacartery to determine patency rate at 1, 3, 12, and 24months after stent placement.Results: The mean age of patients was 64.60 (±10.41).The main symptoms of the patients were claudication(41.8%), ulcer (27.3%), pain at rest (20%), and gangrene(20%). The lesion was bilateral in 21 patients (38.2%).According to TASC stratification, lesions were of type A in26 patients (47.3%), type B in 4 patients (7.3%), type Cin 5 patients (9.1%), and type D in 20 patients (36.4%).The six-month, one-year, and two-year patency rates were89.1%, 83.6%, and 72.7%, respectively. The mean annualABI of patients was 0.79 (±0.11) and two year ABIwas 0.68 (±0.1).Conclusion: It seems that stenting and angioplasty areeffective in improving patients’ conditions and result in agood short and medium-term patency

A study on job postures and musculoskeletal illnesses in dentists

Objectives: Musculoskeletal disorders (MSDs) compose a large part of occupational diseases in dental professionals, prevention of which is dependent on assessment and improvement of job postures by means of ergonomic interventions. This study was aimed at evaluation of ergonomic conditions of the profession of dentists and also at assessing the relationship between MSDs and conditions of work. Materials and Methods: This cross-sectional study was performed among 65 dentists using the method of Rapid Entire Body Assessment (REBA). The prevalence of MSDs was obtained by the use of the Nordic Musculoskeletal Questionnaire (NMQ). Results: In this investigation, the prevalence of MSDs for different body parts was: 75.9% for the neck, 58.6% for the shoulders, 56.9% for the upper back, 48.3% for the lower back and 44.8% for the wrist. Job analysis by the use of REBA showed that 89.6% of limbs in group A and 79.3% of limbs in group B had a score > 4. Only neck and lower back pain have significant relationship with the risk levels obtained using the REBA method. Conclusions: It can be concluded that work postures of dentists need to be improved. In addition to education, work station design, rest period during work and regular physical activities should be taken into account

A study on job postures and musculoskeletal illnesses in dentists

Objectives: Musculoskeletal disorders (MSDs) compose a large part of occupational diseases in dental professionals, prevention of which is dependent on assessment and improvement of job postures by means of ergonomic interventions. This study was aimed at evaluation of ergonomic conditions of the profession of dentists and also at assessing the relationship between MSDs and conditions of work. Materials and Methods: This cross-sectional study was performed among 65 dentists using the method of Rapid Entire Body Assessment (REBA). The prevalence of MSDs was obtained by the use of the Nordic Musculoskeletal Questionnaire (NMQ). Results: In this investigation, the prevalence of MSDs for different body parts was: 75.9% for the neck, 58.6% for the shoulders, 56.9% for the upper back, 48.3% for the lower back and 44.8% for the wrist. Job analysis by the use of REBA showed that 89.6% of limbs in group A and 79.3% of limbs in group B had a score > 4. Only neck and lower back pain have significant relationship with the risk levels obtained using the REBA method. Conclusions: It can be concluded that work postures of dentists need to be improved. In addition to education, work station design, rest period during work and regular physical activities should be taken into account