Journal of Surgery and Trauma
Volume:3 Issue: 3, Winter 2015

Tonsillectomy is one of the most common surgeries all over the world and is performed by various methods. This study aimed to investigate the complications of bipolar electrocautery method of tonsillectomy.
This cross-sectional study was performed on 234 patients, 114 female and 120 male individuals. The mean age of the patients was 12.2±8.3 (min=3 and max=58.2) years. Some parameters including duration of surgery, intraoperative blood loss, postoperative hemorrhage, severity of pain were measured 4 and 24 hours after operation. The data were analyzed by SPSS software (Version 15) using Mann-Whitney, Kruskal-Wallis and Spearman tests. P values less than 0.05 were considered significant.
In our study, the mean duration of surgery was 12.7±4.5 minutes, mean intraoperative blood loss was 36.6±10.8 ml, and postoperative hemorrhage was observed in 3.4 % of patients. The mean pain scores 4 hours after operation were 2.1±0.7 and 2.7±0.8 for age groups below and over 10 years old respectively, while these scores were 2.4±0.8 and 3.2±1 after 24 hours of operation for them respectively with the difference being significant (p In our study, mean intraoperative blood loss, postoperative hemorrhage, and duration of surgery were greater than what has been reported in the majority of previous studies.

Abnormal uterine bleeding (AUB) is among the most complex gynecological problems, especially during the middle and old age. The aim of this study was to assess the pathological findings in endometrial curettage samples of abnormal uterine bleeding and the risk factors associated with them.
In our cross-sectional study, we included all the referring women with AUB complaint to Birjand’s Vali-e-Asr hospital gynecology clinic from August 2014 to February 2014. The data were collected via interviews and dilatation and curettage (D&C) pathologically evaluated.
A total of 152 patients were enrolled. The mean age of participants was 44.09 years. The most common manifestations were menorrhagia, metrorrhagia, and menometrorrhagia with frequencies of 66 (43.4%), 53 (34.9%), and 160 (10.5%), respectively. The most frequent pathological findings were normal pattern (51.7%, n=78), polyps and abnormal endometrial proliferation (29.1%, n=44), and hyperplasia (14.6%, n=22). No significant association was found between the pathologic results and age, bleeding on admission, number of pregnancies, contraception procedure, occupation, history of endometrial hyperplasia, history of ovarian cysts, hypothyroidism, hyperthyroidism, hyperprolactinemia, hypertension, and diabetes.
Overall, the most common causes of AUB involve non-organic causes, that is, natural causes although curettage is still an acceptable method for assessment of AUB, given the importance of AUB in diagnosis of endometrial cancers in women over 40 years old.

Cataract is a common disease across the world and the most common cause of vision loss and blindness. Several factors contribute to the disease, the most important of which is aging. Other contributors include sex, smoking, sunlight, place of residence, family, job, and systemic disease. This study was aimed to enquire into the epidemiology of cataract cases referred to Noor Ophthalmology Clinic of Birjand from March 2015 to February 2016.
In this descriptive and cross-sectional study, the patients with cataract admitted to Noor Ophthalmology Clinic in Birjand from March 2015 to February 2016, who were available, were selected. A total of 386 patients were selected. Information was collected by a checklist concerning variables such as age, sex, smoking history, diabetes, location, separate left and right eye, family, job, and cataract diagnosis. Their records were collected, and the obtained data were analyzed by SPSS software (V: 16). The significant level was set at P The majority of the 386 cases under study were women (56.5%). The mean age of patients was 67.4±2.9 years. Cataract was more commonly seen in the right eye, diabetes (13.50%), hypertension (21.1%), and urban (31.9%) and rural (68.1%) areas. The prevalent cataract types were respectively nuclear cataract, cortical cataract, and sub-capsular cataract.
As cataract is one of the common eye diseases which is of more prevalence in elderly age group (50-79) and housewives, special attention should be given to these groups of population in order to prevent and control cataract.

Anxiety and depression are among major problems encountered by most patients after cardiac surgery. They can have serious consequences for patients’ quality of life, physical and psychological morbidity, and follow-up treatments. Accordingly, the present study was conducted to determine the status of depression and the associated factors in coronary artery bypass grafting (CABG) patients hospitalized in cardiac surgery ward of Imam Reza Hospital of Mashhad in 2013.
The current investigation is a descriptive, cross-sectional study for which all patients undergoing CABG surgery were selected using the census method. The subjects included inpatients hospitalized in Imam Reza (AS) Hospital of Mashhad from April 2013 to March 2014. The data was collected using the demographic characteristics form as well as Beck Depression Inventory (BDI-II). Analysis of data was conducted with SPSS (version 16) using paired t-test, independent t-test, ANOVA and Pearson correlation coefficient. The significance level was set at P The mean score of depression after cardiac surgery was 31.5±10.60 and 29.3±10.55 for male and female patients, respectively. From among the patients, 64.4% suffered from severe depression after surgery, while 32.1% had moderate depression. No statistically significant relationship was found between age, sex, marital status, employment status, and education level on the one hand and post-operative depression score on the other hand.
As regards the high rates of pre-surgical and post-surgical depression in patients undergoing CABG, effective communication with patients and patient training are recommended as critical components of nursing care to reduce depression.

Paroxysmal nocturnal hemoglobinuria (PNH) is a rare hematologic disorder that manifests with hemolytic anemia, thrombosis, and peripheral blood cytopenias.Acute abdominal pain is one of the PNH clinical manifestations due to venous thrombosis of intra-abdominal sites including hepatic, portal, mesenteric, and splenic veins.Eculizumaband allogeneic bone marrow transplantation (BMT) arethe only widely effective therapies for these patients.
We report a case of PNH disorder which presented with abdominal pain and mild tenderness. Abdominal X ray and sonography revealed intra-peritonealfree fluid and air. At laparotomy, an ischemic segment of jejunum with stricture and perforationwith mesenteric venous thrombosis were found. The patient also had a history of hepatic vein thrombosis two years before.

Aortic coarctation is a rare but dangerous condition. Presence of aortic dissection in addition to coarctation is significantly rarer and more life-threatening. Here, we present a case of acute inferior MI due to aortic dissection complicating a native aortic coarctation.
A 17-year-old boy was admitted to our emergency department due to severe chest pain and loss of consciousness. His electrocardiogram showed ST elevations in Inferior leads proposing an inferior MI. Further evaluations revealed that the patient had been suffering from an underling aortic coarctation complicated by an acute aortic dissection.
For every young person with symptoms of acute coronary syndrome, aortic dissection should be considered as a potentially fatal differential diagnosis. Coexistence of aortic coarctation, as an underling and exacerbating factor, should be assessed using appropriate imaging modalities whenever suspected.

Pancoast tumor accounts for 3%-5% of all non-small cell lung carcinomas. This tumor has a distinct clinical presentation through local invasion and the resulting clinical entity called Pancoast syndrome. This syndrome includes severe shoulder pain, arm pain, and Horner’s syndrome andatrophy of forearm and hand muscles. The differential diagnosis of arm and shoulder pain is extensive. Thoracic outlet syndrome and cervical disk disease are commonly mistaken for the Pancoast syndrome in the early clinical course. Diagnosis of Pancoast tumor is often late, and misdiagnosis is a common problem that can affect the prognosis. Therefore, Pancoast tumor should always be considered in differential diagnosis of radicular pain of the upper extremity.
We report a case of 55-year-old man who was admitted with right side severe pain in the back of the neck, shoulder and arm with numbness and tingling sensation in the medial aspect of the forearm and 4th and 5th fingers. These symptoms had initiated from 17 months ago, and the patient was treated for cervical discopathy and frozen shoulder.

Despite all the diagnosis and treatment processes of pulmonary thromboembolism (PTE), it is still associated with a high rate of mortality. We describe a massive PTE case of a 73-year-old woman with unusual clinical manifestations.