The Effect of Piroxicam on the Formation of Postoperative, Intraabdominal Adhesion in Rats

<b>Background/Aims:</b> Peritoneal adhesions are fibrous bands of tissues formed between organs that are normally separated and/or between organs and the internal body wall after peritoneal injury. Antiinflammatory agents were used to reduce the initial inflammatory response to tissue injury and, hence, the subsequent formation of adhesion. The aim of this study was to investigate the effect of intraperitoneal instillation of piroxicam on intraperitoneal adhesions. <b> Methods:</b> Eighty Wistar rats were subjected to standardized lesion by using the scraping model and were randomly divided into four groups. Group I (control) received no treatment; groups II, III, and IV received 10-12.5 mL of 0.05, 0.1, and 0.2 mg/mL piroxicam solution, respectively, after surgery. On the 14th postoperative day, the adhesion intensity score, inflammatory cell reaction, and the number of adhesion bands were determined. <b> Results:</b> There were no rats with grade 0 adhesions in the control group. There were 10 rats (50&#x0025;) with grade 2 and eight rats (40&#x0025;) with grade 3 adhesions. The adhesion intensity (<i> P</i> &lt; 0.0001) and the number of adhesion bands (<i> P</i> &lt; 0.001) were significantly lower in groups III and IV. No significant difference was observed in the adhesion intensity or the number of adhesion bands between groups I and II. <b> Conclusions:</b> Intraperitoneal instillation of piroxicam solution might be useful for preventing peritoneal adhesions

Giant prosthetic reinforcement of the visceral sac : The Stoppa groin hernia repair in 234 patients.

<b>Background: </b>Recurrent and complex bilateral inguinal hernias are associated with a high recurrence rate. Giant prosthetic reinforcement of the visceral sac (GPRVS) is popular in America and Europe, but there are no prospective data from Iran. <b>Patients and Methods: </b>From 20 March 1995 to 20 March 2003, 234 patients (227 men and 7 women) with 420 inguinal hernias (186 bilateral and 48 unilateral) underwent repair using a large polyester mesh based on Stoppa`s preperitoneal technique. Mean age was 60 years (range 25 to 88) and 44.8&#x0025; had one or more comorbid conditions. In 154 instances, the relapsed hernia had already been operated once or twice for recurrence. <b>Results: </b>Mean hospital stay after surgery was 2.2 days (range 1-13 days). The mean operative time was 45 minutes (range 30-75 minutes). General complications were one case of upper gastrointestinal bleeding, one case of ileus and one case of atelectasis. Local complications consisted of three local seroma formations. In no instance was postoperative neuralgia, chronic pain or testicular atrophy, mesh infection or death reported. Follow-up was obtained in all patients. The recurrence rate was 0.71&#x0025; (3 of 420) per inguinal repaired or 0.85&#x0025; (2 of 234) per patient. Factors predicating a high risk for recurrence included large hernia size (>5 cm), failure of one or more previous repairs (65.8&#x0025;, 154 of 234), chronic cough and associated lower abdominal hernias. <b>Conclusion: </b>GPRVS is anatomic, sutureless, tension-free and the absolute weapon to eliminate all type of groin hernias. No other technique produces better results for the repair of recurrent and re-recurrent groin hernias

Efficacy of Fibrin Glue on Seroma Formation after Breast Surgery

Background and Objectives. This study was designed to determine the effectiveness of fibrin glue plus conventional drain placement versus conventional drain placement in the prevention of seromas after breast procedures. Among methods employed to reduce seroma magnitude and duration, fibrin glue has been proposed in numerous studies, with controversial results. Design and Setting. A prospective, randomized, controlled study of subjects who were randomized into control and experimental groups was conducted. Methods. Collected data included age, surgeon, medical and surgical history, comorbidities, procedure performed, number of axillary nodes, number of positive axillary nodes collected, final pathologic diagnosis, cancer stage, hospital stay, postoperative day of drain removal, complications, incidence of seroma formation, interval to seroma resolution, and number of postoperative visits. Results. Analysis of 60 patients showed similarly matched groups. Seroma formation rate was 24.1% in the control group and 16.1% in the fibrin glue group. The rate of wound complications was similar. Conclusions. Although use of fibrin sealant resulted in a nonsignificant decrease in seroma formation rate compared with that of drain placement, the higher cost and cumbersome technique tend to indicate that there is no advantage to using fibrin glue over drain placement with the technique described

Cognitive distortions as trauma-specific irrational beliefs among burn patients

Burn injuries are most certainly stressful events, particularly when permanent disfigurement is a result. This situation can lead to the onset of irrational beliefs which can in turn lead to long-term psychological problems such as depression, anxiety, shame, guilt, posttraumatic stress, etc. The objective of this study is to explore the irrational beliefs among burn patients and its correlates in an Iranian sample. This cross-sectional study included 329 patients who had experienced disfigurement, as result of burn injuries. In order to assess irrational beliefs, a Scale for Irrational Thoughts after Burning was used. To identify correlated variables with irrational beliefs, both bivariate and multivariate analysis methods were conducted. In multivariate linear regression, forward strategy was used for building the model. The results of bivariate analysis showed that the location of the burn on bodies (body parts generally exposed in social environment or parts culturally perceived as sensitive areas of body), marital status, urbanities, age group, geographical areas, etiology of burning, and intent of injury had significant relationships with irrational beliefs (P &lt; .05). Using forward linear regression, gender, marital status, geographical areas, etiology of burning, body burn by location (body parts generally exposed in social environment or parts culturally perceived as sensitive areas of body), and intent of injury had significant correlation with irrational beliefs. The models predicted 15.5% (P &lt; .001) of irrational beliefs. Considering to irrational beliefs and development of facilities for screening is necessary. Moreover, consultation with mental health experts after burn injuries is highly recommended

Irrational thinking and its predictors among burn patients

BackgroundBurn injuries are most certainly stressful events, particularly when permanent disfigurement is a result. This situation can lead to the onset of irrational beliefs which can in turn lead to long-term psychological problems such as depression, anxiety, shame, guilt, posttraumatic stress, etc.The objective of this study is to determinate predictors of irrational beliefs among burn patients in Iran.MethodThis cross-sectional study was carried out on a total of 329 burn patients. In order to assess irrational beliefs, Scale for Irrational Thoughts after Burning (SITB) was used. To identify predictors of irrational thoughts, both bivariate and multivariate analysis method were conducted. In multivariate linear regression, forward strategy was used for building the model. Preliminary variable selection for model design was based on a p&lt;0.2 and final decision for keeping the variables in the model was based on a p&lt;0.05.ResultsThe results of bivariate analysis showed that body burned location (body parts generally exposed in social environment or parts culturally perceived as sensitive areas of body), marital status, urbanities, age group, geographical areas, etiology of burning and intent of injury had significant relationships with irrational thoughts. (p&lt;0.05) Using forward linear regression, gender, marital status, geographical areas, etiology of burning, body burned location (body parts generally exposed in social environment or parts culturally perceived as sensitive areas of body), and intent of injury were significant predictors of the SITB. The models predicted 15.5 percent (p&lt;0.001) of irrational thoughts.ConclusionConsidering to irrational thoughts and development of facilities for screening is necessary. Moreover, consultation with mental health experts after burn injuries is highly recommended