Journal of Surgery and Trauma
Volume:3 Issue: 1, Summer 2015

Valvular heart lesions have deleterious effects on hemodynamics in parturients during pregnancy. Cesarean section with an opioid-based general anesthesia is used to alleviate the adverse effects. We described a case of a 28-year-old primigravida at 37 weeks’ gestation with a diagnosis of severe mitral regurgitation, tricuspid regurgitation, and pulmonary hypertension in active labor. Cesarean section under general anesthesia using remifentanil was planned to provide a stable anesthesia and analgesia to minimize hemodynamic changes during surgery. The patient maintained reasonable hemodynamics during surgery. The neonate required transient ventilatory support with bag and mask until she obtained spontaneous respiration.
We suggest that remifentanil is a reliable opioid that can produce stable hemodynamic conditions with transient neonatal respiratory depression during cesarean section under general anesthesia in a parturient with severe valvular heart disease and pulmonary hypertension.

Ewing's sarcoma is a relatively common malignant bone tumor that typically occurs in long bone diaphyses of adolescents and young adults of 10-30 years old. Often times, all Ewing's sarcoma of bone have radiographic abnormalities. Diagnosis is usually delayed and can be misdiagnosed as osteomyelitis. Bone to bone metastasis occurs, but soft tissue retro bulbar metastasis is rare. This article presents a 32-year-old man with Ewing's sarcoma of proximal tibial epiphysis, without any radiographic finding, that was treated as osteomyelitis and progressed as a retro bulbar mass.

Postoperative wound infection is a complication that occurs after coronary artery bypass graft surgery. The aim of this study was to examine the incidence of wound infections after coronary artery bypass graft surgery among the patients operated in Ghaem Hospital in the city of Mashhad from 2009-2011.
This cross-sectional study was performed in the years 2009 to 2011 on 360 patients who underwent open heart surgery in Ghaem Hospital in Mashhad city. Data collection instruments consisted of demographic characteristics form and questionnaires concerning history of diseases, site of wound infection, depth of wound (deep or superficial), and the type of micro-organism growth. Patients were followed for 3 months, and the incidence of sternal and lower extremities wound infections was recorded. The data were analyzed in SPSS (V: 16) using chi-square test. The significant level was set at p We evaluated 360 patients undergoing coronary artery bypass graft surgery. The total prevalence of wound infection after surgery was 84 (36%). From among patients who had wound infections, 54 patients (64.5%) had superficial infection (8.3% of the total) and 30 patients (36%) had deep infection (15% of the total). Sternal wound infection after surgery was observed in 49 patients (58%) and lower extremity in 35 cases (42%). Micro-organisms that grew in the cultivation of the sternum area included 8​​ cases of Enterococci cases, 9 Staphylococci cases, and 29 negative cultures. In foreleg area, 3 cases were Enterococci, 5 Staphylococcus cases, and 32 negative culture.
Our findings confirm that the postoperative wound infection after coronary artery bypass graft surgery is a common complication and new preventive strategies should be developed to reduce it.

Pterygium is characterized by an elastic degeneration of the conjunctiva that extends across the limbos and invades the cornea. The recurrence rate is varied from 25-80% after primary closure to 6% with free conjunctival and Iimbal grafts. Several adjunctive therapies have been investigated for recurrent pte¬rygium. This article presents a 52-year-old athletic man who was seen for evaluation of a recurrent lesion in his right eye and treated with topical administration of IFN-α-2b (Intron A, Schering Plough, Kenilworth, NJ), 1 million units/mL 4 times a day as eye drops.

Root fractures are defined as fractures involving dentine, cementum, and pulpal and supportive tissues. They comprise about 0.5–7% of all dental injuries. Horizontal root fractures are commonly observed in the maxillary anterior region and 75% of these fractures occur in the maxillary central incisors.
Case report: This case report is about a 26-year-old male referred to the endodontic department of Zahedan dental school 3 days after motorcycle accident. Radiographic examination shows a horizontally root fracture of the right mandibular central incisor in the apical third. Initially, the coronal fragment was repositioned and this was radiographically confirmed. Then, the stabilization splint was applied and remained for 50 days. Two weeks splinting which radiographic examination showed the lesion adjacent to the fracture line, the two visit endodontic treatment of the coronal portion was started and the root canal was obturated with gutta percha points.
One-year follow-up examination revealed the clinical and radiographic signs of healing with hard tissue repair of the fracture line.

Along with advances occurring in cardiopulmonary bypass (CPB) including improved anesthesia intubation and early surgical interventions, it has become possible to correct life-threatening congenital heart anatomic abnormalities in patients. Our study aimed to collect information from one of the most important centers of pediatric cardiac surgery in Iran since there is limited information in this field in our country.
In this study, the results of pediatric cardiac surgery and mortality were studied for two years. A retrospective, descriptive study was carried out on 789 patients within two years. 401cases were excluded as they had congenital heart disease complexity. The patients were referred from other pediatric cardiac medical centers. Information related to kinds of surgical operation and deaths were collected from patient's documents and questionnaire. The data were analyzed by descriptive statistical tests in SPSS version-16.
The age range of patients varied from three days to 18 years. The male/female ratio was 53.4%. CPB was not applied for 21.1% of patients. The frequency of operations included PDA (Patent Ductus Arteriosous) [D&L] (%8.5), total correction for TF (Tetralogy of Fallot) (%16.7), systemic to pulmonary shunt (%26.5), ASD (Atrial Septal Defect) and VSD (Ventricular Septal Defect) closure (%5.4) and (%28), respectively as well as coarctationrepaire (%14.6). Total mortality rate was 8.6%. Analysis of the operated population showed that outcome of patients has improved in recent years.
Compared with other studies, the results of our investigation showed that children's congenital heart surgery is on the rise.