Analysis of the Results of Pulmonary Resection by Minimally Invasive Thoracoscopy for the Surgical Treatment of Lung Cancer

Introduction: Lung cancer is the disease of modern era, and the rate of lung cancer mortality is three times as high as that for prostate cancer and twice as high as the rate for breast cancer. We aimed to analyze the results of pulmonary resection in patients with NSCLC by minimally invasive thoracoscopy.  Materials and Methods: We studied 10 patients with NSCLC scheduled for surgical resection by minimally invasive video-assisted thoracoscopic surgery (VATS) in Ghaem Hospital, Mashhad, Iran, during March, 2015-February 2016. The patients were analyzed with respect to age, gender, pathology, surgery type, surgical complications and turning into open surgery, hospital-acquired complications, and mortality rate six months and one year post-operation.   Results: We found that 60% of the patients were male. The patients were within the age range of 47-75 years. The analysis of lesion location showed that most lesions were in the lower lobe of the left lung (50%). None of the VATSs turned into open thoracotomy surgeries. Postoperative complications were observed in 3 (30%) patients. Further,  5 (50%) patients had squamous cell carcinoma (SCC), 4 (40%) of the patients had adenocarcinoma, and 1 (10%) had LCC. The surgical mortality analysis of the patients showed that only one male patient (a 72-year-old patient) died five days after wedge resection due to myocardial infarction. In the six-months and one-year follow up of the nine remaining patients, no cases of death had occurred.  Conclusion: It seems that pulmonary resection by minimally invasive VATS has considerable advantages compared to open surgery, including higher effectiveness, shorter intensive care unit (ICU) stay, higher survival rate, and greater patient satisfaction

Depression, anxiety and quality of life in caregiver spouses of veterans with chronic spinal cord injury

Objective: We were curious about the degree of anxiety and depression and their effect on the quality of life of the caregivers of veterans with spinal cord injury (SCI). Methods: A convenience sample of 72 out of 120 caregiver spouses of veterans with spinal cord injury participated in our study. The Hospital Anxiety and Depression Scale (HADS) were considered as a measure of depression and anxiety. The World Health Organization Quality of Life BREF questionnaire (WHOQOL-BREF) was considered to evaluate the quality of life. To compare the caregivers, we enrolled 74 matched caregiver spouses of patients without spinal cord injury. Results: The average age of the spouses was 44.7±6.5. The average time elapsed from the injury was 26.4±3.1 years. There was a significant difference in all domains of quality of life and depression between the caregivers and the control group, but there was not a significant difference in terms of anxiety. There was a negative correlation between depression and age, level of education and quality of life. Conclusion: Mental care support should be implemented for veterans and their spouses in addition to the provided facilities

Quality of life and the related factors in spouses of veterans with chronic spinal cord injury

BACKGROUND: The quality of life (QOL) of caregivers of individuals with chronic spinal cord injuries may be affected by several factors. Moreover, this issue is yet to be documented fully in the literature. The purpose of this study was to evaluate the health related quality of life of spouses who act as primary caregivers of veterans with chronic spinal cord injuries in Iran. METHODS: The study consisted of 72 wives of 72 veterans who were categorized as spinal cord injured patients based on the American Spinal Injury Association (ASIA) classification. Health related quality of life was assessed by the Short Form (SF-36) Health Survey. Pearson's correlation was carried out to find any correlation between demographic variables with SF-36 dimensions. To find the effect of the factors like age, employment status, duration of care giving, education, presence or absence of knee osteoarthritis, and mechanical back pain on different domains of the SF-36 health survey, Multivariate analysis of variance (MANOVA) was used. RESULTS: The mean age of the participants was 44.7 years. According to the ASIA classification 88.9% and 11.1% of the veterans were paraplegic and tetraplegic respectively. Fifty percent of them had a complete injury (ASIA A) and 85% of the spouses were exclusive care givers. All of the SF-36 scores of the spouses were significantly lower than the normal population. Pearson's correlation demonstrated a negative significant correlation between both age and duration of caring with the PF domain. The number of children had a negative correlation with RE and VT. CONCLUSION: The burden of caregiving can impact the QOL of caregivers and cause health problems. These problems can cause limitations for caregiver spouses and it can lead to a decrease in the quality of given care

Evaluation of the validity and reliability of the Persian version of Iowa Satisfaction with Anesthesia Scale in Iran

Introduction: The interaction between the doctor and the patient achieved when the physician is able to communicate effectively with the patient. Iowa Satisfaction with Anesthesia Scale is a tool for this purpose. Given that ISAS is originally in English and understudy in Iran, we decided to translate this scale into Persian and evaluate its validity and reliability.Purpose: Our aim in this study is translating, validity and reliability of ISAS.Methods: This study is an observational study with a correlational design that adopts an analytical approach. The population consisted of all patients undergoing surgery at Imam Reza Hospital out of whom 162 patients met the inclusion criteria, i.e. aged 18 years and above, transferred from the OP to ICU, exposed to general anesthesia and signed the consent form.Results: Patients completed the questionnaire in 5 minutes. The mean (maximum-minimum) age of the patients was 57.39 (18-87). As for gender, 102 (63%) of patients were male and 56 (34.6%) were female. About 4 (2.5%) of the data went missing. Cronbach's Alpha was 0.85. The correlation analysis showed that Iowa scale was significantly correlated with RP (P = 0.007), BP (P = 0.002), RE (P = 0.007) and GH (P = 0.012). The PSQ questionnaire had a significant correlation with the LOWA questionnaire (p < 0.001).Conclusion: Validity and reliability of the Persian version of Iowa Satisfaction with Anesthesia Scale (ISAS) in Iran are excellent

Identifying predisposing factors for recurrence after successful surgical treatment of lumbar disc herniation

Background: Recurrent lumbar disc herniation (rLDH) comprises one of the most common complications of lumbar discectomy occurring in about 1-21% of the operated patients. Aim: This study aims to elucidate the role of predisposing factors in producing rLDH in the patients with previous successful lumbar discectomy. Materials and Methods: In this retrospective study, we reviewed 213 patients (133 male; 62%) who underwent simple primary lumbar discectomy in our Orthopedic Department from August 2009 to January 2014. Mean age and follow-up period were 38.1 ± 9.8 years and 48.2 ± 7.3 months, respectively. The term of rLDH referred to those cases who have suffered a relapsed sciatalgia after a primary pain improvement period. We repeated magnetic resonance imaging (MRI) scanning only in those cases with recurrent complaints. Chi-square, Fisher, and Student's t-tests were used for statistics. Results: Recurrent sciatalgia occurred in 39 patients (18.3%), while true rLDH on MRI scanning was detected in 32 patients (15%). Younger age, heavier smoking, and less severity of herniation on primary MRI scanning (protrusion vs. sequestration) play as predisposing roles in creating rLDH, while gender, level or side of LDH, the presence of Modic changes, or body mass index (BMI) have no significant effect. The most common sites of rLDH were same level same side, different level, and same level contra-lateral side, respectively. Conclusion: In the patients who had been successfully treated by simple primary lumbar discectomy, younger age, heavier smoking state, and less protrusion of the herniated disc at the time of the index surgery, were all correlated with more probability of the future rLDH, while BMI, Modic change, sex, level, and side of LDH had no significant role