Evaluation of Early Removal of Urinary Catheter after Rectal Cancer Surgery

Background: It is a common practice to catheterize the bladder during major surgical procedure and leave the catheter in situ to avoid post-operative urinary complications such as retention or incontinence. Catheter removal on post-operative day 5 is a routine, and it causes some urinary problems and longer hospital stay. The objective of this study was to evaluate the effect of early removal of urinary catheter on the 1st day after rectal cancer surgery, on the rate of urinary complications.Methods: This quasi-experimental study was approved by the Ethics Committee of Shahid Beheshti University of Medical Sciences, Iran. 80 patients with rectal cancer underwent surgery at Imam Hossein Hospital from 2015 to 2016, were recruited with planned early removal of urinary catheter after surgery. Personal and disease information was recorded in all patients after obtaining the informed consent. Urinary complications were checked by the surgical resident after the operation.Results: Mean age of participants was 56.64 ± 14.90 (range: 22-84 years). From these patients 46 (57.5%) were male, and 34 (42.5%) were female. Two cases (2.5%) were manifested urinary problems in men. One of them reported urinary retention and the other one had hematuria. Both patients were in Stage III of rectal cancer and had laparoscopic surgery. Urinary incontinence was not reported in any patients.Conclusions: In patients who undergoing rectal cancer surgery, urinary catheter can be removed on the 1st post-operative day without any significant increase in urinary complications

Review of Unusual Presentations of COVID-19

The world has faced the coronavirus disease 2019 (COVID-19) pandemic since the H1N1 influenza pandemic in 1918. The symptoms of this disease are spreading rapidly and affect almost all systems of the body. In addition to the common symptoms of the virus, numerous reports of rare symptoms of the virus have also been published. These atypical presentations can result in difficulty in diagnosing the disease. The aim of this work is to summarize “uncommon atypical presentations”, which have not received enough attention in descriptions of the disease presentation to date and the authors specifically discuss the important uncommon atypical presentations of COVID-19

Early Versus Delayed (Traditional) Postoperative Oral Feeding in Patients Undergoing Colorectal Anastomosis

Background: A period of starvation after colorectal anastomosis to permit for resolution of the clinical evidence of ileus has been an unchallenged surgical dogma until recent years. We intended to determine the safety and feasibility of an unconventional postoperative oral intake protocol in patients experiencing colorectal anastomosis. Materials and Methods: Between 2013 and 2015, sixty consecutive patients underwent colorectal anastomosis and they were randomized into two groups. The early feeding group began fluids on the first postoperative day while the regular feeding group was managed in the traditional way - nothing by mouth until the complete resolution of ileus. Results: The majority of patients (93%) tolerated the early feeding. The times to first passage of flatus (2.66 ± 0.71 days vs. 3.9 ± 0.071 days) and stool (3.9 ± 0.92 days vs. 5.4 ± 0.77 days) were significantly quicker in early feeding group. Hospital stay was also significantly shorter in the early feeding group (4 ± 0.64 days vs. 6.1 ± 0.84 days). Anastomosis leakage and abscess formation were not seen in early feeding group. The patient's satisfaction (visual analog scale) in the early feeding group was higher than delayed feeding group (8.56 ± 1.16 vs. 7.06 ± 1.59, P < 0.001). Conclusions: Early oral feeding after colorectal surgeries is safe and tolerated by the majority of patients

Revealing the Key Proteins under Telecommunications’ Tower in Brain Tissue of Rats through Proteomics Approach: Biological effects of ELF/EMF on Brain’s tissue

Introduction: Although there are a lot of interests in telecommunications tower approaches in view of Cancer, limited researches have studied the molecular pathways, which are enriched under ELF/EMF. The aim of this study is investigating the key proteins, affected by by Tower. Materials and Methods: In this study, 30 Rats under wavelength electromagnetic waves (RF900 MHz) were randomly selected. Two-dimensional electrophorese was performed to study proteomics of Rat’s brain. Results: Totally, 26 differentially uttered proteins (DEPs) were categorized by cytoscape network analysis. Conclusion: Some key proteins in view of cancer are regulated under the face of a non-standard (unconventional) radio frequency radiation, which can induce the complement and coagulation cascades pathway. &nbsp

Cellular Effects of Wound Fluid (Seroma) from Tumor Bed on Human Breast Cancer Cell Lines: Seroma in breast cancer cell lines

Introduction: Post-lumpectomy wound fluid (seroma) contains many proteins from tumor bed due to physiologic answer to operation and wound healing process. Some cellular tests had been performed on different types of breast cancer (BC) cell lines and normal cell line while treated with seroma. Materials and Methods: The wound fluid samples were collected from BC patients. The human BC cell lines included MCF-7, MDA-MB-231 as well as normal non-tumorigenic epithelial cell line (MCF-10). Results: Seroma could inhibit various cancer cells proliferation pattern in comparison with the normal cell. Concerning the cell death, aggressive MDA-MB-231 cells were put into the apoptosis process. Besides, seroma could decrease colony count and size and changed the clone morphology from holoclone to paraclone. Regarding the invasion assay, seroma significantly inhibited cell motility. Conclusion: By remaining in tumor bed, seroma can induce inhibitory pattern of proliferation, and change the morphology of cancer cell colony and cell motility, consequently leading to positive impact on patients who suffer from&nbsp;&nbsp; cancer

Superior Mesenteric Artery Aneurysm in A Patient With Chronic Abdominal Pain

Superior mesenteric artery (SMA) aneurysm is a rare disease. In this case report, we present a 32 years old woman who was admitted to our hospital with chronic abdominal pain. SMA aneurysm was diagnosed after radiological evaluation. The patient underwent ligation of the superior mesenteric artery aneurysm and remained well 12 months after the surgery

Congenital Nasopharyngeal Teratoma in a Neonate

Background: Congenital germ cell tumors are uncommon. The most common site of teratoma is in the sacrococcygeal region. Teratoma arising from the head and neck comprises less than 10% of reported cases and of these, nasopharyngeal lesions are rare. Teratomas are generally benign, and have a well recognized clinical and histopathological entity. We present a case of nasopharyngeal teratoma (NPT) associated with a wide cleft palate. Case Presentation: A 20 day old female neonate with a teratoma of the nasopharyngeal area, and wide cleft palate was referred to our center. The protruded mass which measured 6x4x3cm, was of soft consistency, blocked the airway, and prevented oral feeding. Preoperative evaluation and imaging was performed and mass was excised 2 days after admission. Pathology revealed a well-differentiated mature solid teratoma (hairy polyp). The patient had no complication in the post-operative period. Cleft palate was surgically repaired when 2 years old. She is now a six year old girl with normal development. Conclusion: Congenital nasopharyngeal teratomas are usually benign. Surgery is the treatment of choice, and should be undertaken on an urgent basis, especially in a patient who presents with signs and symptoms of airway obstruction

A case report of primary isolated extrahepatic hydatid cyst of the soft tissues of the breast and thigh.

INTRODUCTION: Hydatid Disease (HD), or hydatidosis or echinococcosis, is an endemic infection and a major public health concern in the Mediterranean region. At times it involves the primary soft tissues, such as in the breast and muscle, though this is quite uncommon even in endemic areas. PRESENTATION OF CASES: A. A 31 year-old woman complained of a gradual progressive, painless lump in the left axillary tail of spence for two years. Examination revealed a firm lump measuring 5cm × 5cm, non-mobile, in the left axillary tail of Spence. B. A 32 year-old woman presented with mild and continuous pain in lateral aspect of left thigh. On examination, there was a round, non-tender, non-mobile mass in the lateral aspect of her left thigh. Preoperative imaging studies in both patients revealed evidence of HD. Both of the patients underwent surgery and received Albendazole twice per day for 10 days, before and three months after surgery. DISCUSSION: The disease can be diagnosed by serological and radiological modalities, both of which are not definitive. Ultrasonography should be the first diagnostic modality of soft tissue HD, however, MRI can be used to understand clearly the surgical involvements of structures. The standard treatment of soft tissue HD is surgery using pericystectomy techniques, as well as anthelmintic therapy. CONCLUSION: HD should be suggestive in soft tissues if mass is slowly developing and presenting with local extension, particularly in endemic countries. Excision of HD using pericystectomy technique is the first choice of intervention for HD of soft tissues

انسداد روده ناشی از بزوار، بررسی 19 مورد

مقدمه: بزوار مواد هضم نشده ای هستند که به علل مختلف در دستگاه گوارش باقی مانده اند و باعث بروز علائم و عوارض متنوع می شوند. یکی از عوارض نادر بزوار انسداد روده است که در این مطالعه بررسی شده است. روش کار: این مطالعه بصورت بررسی موارد(case series) در بازه زمانی 2 ساله از سال 1395 الی 1397 کلیه بیمارانی که با تشخیص انسداد روده باریک در بیمارستان امام حسین (ع) تحت عمل جراحی قرار گرفته بودند و پاتولوژی نهایی بزوار بوده است وارد مطالعه شدند. اطلاعات دموگرافیک و آزمایشگاهی و یافته های حین عمل در این بیماران مورد ارزیابی و تجزیه و تحلیل قرار گرفت. یافته ها: از تعداد 19 بیمار، 12 بیمار (63%) زن و 7 بیمار (37 %) مرد بودند. میانگین سنی بیماران2± 84/63 سال بود.15 بیمار در فصل زمستان و پاییز و 4 بیمار در بهار و تابستان مراجعه کرده بودند.بیماری های همراه شامل دیابت (42%)،سابقه جراحی معده (15%)،کم کاری تیروئید (5%) بود.مواد خارج شده شامل خرمالو (47%)، مواد نامعلوم (38%)، انار(10%)،مو (5%)بود شایع ترین علائم بالینی شامل درد شکم (87%)، تهوع و استفراغ (80%)، عدم دفع گاز و مدفوع (60%) بود. در معاینه بالینی یافته ها شامل دیستانسیون شکم(85%)، صداهای روده ای کاهش یافته (52%) تندرنس شکمی(48%) وDRE رکتوم خالی (45%).در آزمایشات یافته ها شامل لکوسیتوز(78%)، اسیدوز متابولیک (42%)، ازتمی پره رنال (32%) بود. شایع ترین محل های انسداد شامل 100 سانتی متری انتهایی ایلئوم 68.42% (13 بیمار)، ژژنوم 21% (4 بیمار)، معده و روده باریک همزمان 10.52%(2 بیمار).از این تعداد 13 بیمار(68 %) تحت انتروتومی برای خارج سازی بزوار و6 بیمار(31%) تحت دوشیدن بزوار قرار گرفتند. تمامی بیماران پس از طی سیر بهبودی از بیمارستان مرخص شدند. نتیجه گیری: بزوار یکی از علل نسبتا نادر انسداد روده باریک میباشد. در بیمارن مسن و دارای فاکتورهای زمینه ای برای بزوار و همچنین شرح حال مصرف اخیر میوه های با پتانسیل تشکیل بزوار در فصول پاییز و زمستان میتواند در تشخیص انسداد ناشی از بزوار کمک کننده باشد

کرونا ویروس و درد شکم،گزارش 3 مورد لاپاراتومی منفی

The global spread of coronavirus 2019 (SARS-CoV-2) and various reports indicate a change in the symptoms caused by the virus and gastrointestinal symptoms becoming an important part of the diagnostic symptoms of the virus. The most common gastrointestinal symptoms include anorexia, nausea, vomiting, and abdominal pain. The probable cause of abdominal symptoms in these patients is the presence of the virus in the digestive system and stimulation of the immune system, followed by the release of inflammatory mediators leading to manifestation of symptoms in this part of the body, causing symptoms of peritoneal irritation. Due to the high physiological stress of surgery, deciding on surgery in patients infected with the virus, who have abdominal pain and a positive abdominal examination is a new challenge for physicians and medical staff. In this study, we introduce three patients with COVID-19 who underwent surgery due to abdominal pain and a positive abdominal examination for peritonitis but had normal findings in surgery, and surgery increased mortality. &nbsp; &nbsp;گسترش جهانی کرونا ویروس و گزارش های متعدد نشان دهنده تغییر در علائم این ویروس و اضافه شدن علائم گوارشی به بخش مهمی از علائم تشخیصی این ویروس شده است.شایع ترین علائم گوارشی شامل بی اشتهایی و تهوع و استفراغ و درد شکم میباشد. با توجه به استرس فیزیولوژیک بسیار زیاد جراحی، تصمیم گیری در مورد انجام عمل جراحی در بیماران مبتلا به این ویروس با درد شکم و معاینه شکمی مثبت چالش جدیدی برای پزشکان و کادر درمانی است.در این مطالعه ما به معرفی 3 بیمار مبتلا به کرونا ویروس که با علائم درد شکم و معاینه شکمی مثبت از نظر پریتونیت تحت عمل جراحی قرار گرفتند و یافته های نرمال در عمل جراحی داشتند و عمل جراحی باعث افزایش مرگ و میر شد،میپردازی