فهرست مطالب امیراحمد عرب زاده

The prevalence and causes of acute abdomen can be different in various regions and races. Knowing the epidemiology of the disease can prevent unnecessary surgeries and unwanted complications caused by surgery. The present study was conducted with the aim of epidemiological investigation of adult patients with acute abdomen referred to Fatemi Ardabil Hospital from 2020 to 2021.

A cross-sectional descriptive study was conducted during a year with a statistical population of 1031 patients referred to the Emergency Department of Fatemi Ardabil Hospital with abdominal pain. The sampling method was easy non-probability sampling. The information of these patients was collected through a preliminary questionnaire and analyzed using SPSS 16 software.

In this study, the number of 535 participants were male and 496 were female. 53.5% of patients had non-bilious vomiting، 67.6% had normal abdominal function، 53% had anorexia، 16.2% had abdominal distension and 14.3% had fever. 20.1% had pain in the right lower quadrant، 16.1% no tenderness، 15.6% rebound tenderness، 5.4% guarding، 5.8% psoas sign and 16.3% Murphy sign. 27% of abdominal pain was related to appendicitis، 20% to cholecystitis، 15.3% to intestinal obstruction and the lowest number of cases were related to metastasis and ectopic pregnancy with 0.3%.

The best tools available for examining and managing abdominal pain are clinical examination and a comprehensive history.

Managing neck trauma is a challenging issue in the emergency department. Stable-appearing patients may suffer from vascular, laryngeal, or neurologic complications. The patient was a 41-year-old man who was transported to the hospital by a pre-hospital emergency medical service, following a fight and stabbing in the II area of the neck on the right side. The site of the trauma was the middle part of the right side of the neck. The patient was fully conscious. He had spontaneous speech and his airway was open. The patient was transferred to the operating room after the initial procedures in the emergency department. during surgery, the knife was removed from the neck. Clinical management and providing a suitable platform to accelerate the process of interventions can have a favorable effect on the prognosis of patients.

Using medications that decrease postoperative pain and opioid consumption is a widely recommended approach. The aim of this study was to evaluate the efficacy of intravenous Ibuprofen and its complication in controlling pain after abdominal surgery.

This study was a randomized, double-blind, interventional clinical trial. Sixty patients aged 20 to 60 years were candidates for abdominal surgery (inguinal hernioplasty and appendectomy). Patients were divided into two equal size groups (n=30) using a random block design method. The First group received (400 mg IV) ibuprofen every 6 hours for 24 hours as well as (15 microgram/ml bolus) fentanyl pump with PCA. Second group only received (15 microgram/ml blous) fentanyl pump with PCA. 

Demographic characteristics and duration of surgery, ASA class, type of anesthesia and type of surgery were similar in the two groups. Pain severity in 24 postoperative hours was significantly lower in the ibuprofen group compared with the control group. Nausea and vomiting frequency in 24 postoperative hours was significantly lower in the ibuprofen group compared with the control group. Patients belonging to ibuprofen group were significantly more satisfied with their analgesic method.

Results showed that using 400 mg intravenous ibuprofen every 6 hours mitigates postoperative pain, reduces fentanyl consumption and is highly tolerated by patients.

Cancer is the leading cause of death in developed and developing countries, respectively. Microscopic and endoscopic invasive procedures are not routinely suitable for screening gastric cancer, so the need for biomarkers with the ability to detect quickly, easily, and with high sensitivity in the early stages of cancer is strongly felt. This study aimed to evaluate the expression of the Stanniocalcin 2 (STC2) gene in the serum of patients with gastric cancer. Although the incidence of gastric cancer in the world, especially in developed countries such as the United States has decreased in recent decades (1), in Iran the incidence is increasing and this increase is particularly significant in western Iran (2). According to the latest research conducted in 1988 in Iran, the rate of gastric cancer is 9.3 percent and the third most common cancer in the country in the total number of women and men (2). According to research, Ardabil province has the highest incidence of cancer in Iran and the highest incidence of gastric cancer (49.1 cases per 100,000 in men and 25.4 cases per 100,000 in women), which is almost seven times higher than in southern parts of Iran and twice Is higher than the global average (3). Gastric cancer is a multifactorial disease and has a multi-stage process, including cancer-causing factors that can be attributed to multiple infectious, environmental, genetic, and epigenetic factors on genes that suppress and repair tumors, nutrition, lifestyle, age, and race Pointed out (4). In more than half of the advanced cases in people with this disease, no symptoms are observed and it is diagnosed when it has entered the advanced stage, and unfortunately, many of these people die after a short time. The fast and timely disease can increase the 5-year survival rate of infected people up to 60% (5).

Peripheral blood samples were collected from patients with primary gastric cancer as well as volunteers in tubes containing EDTA anticoagulants. Samples were immediately isolated from serum. Total RNA was extracted from the serum of control and patient samples. The cDNA was then synthesized using the Omniscript Reverse Transcriptase enzyme produced by the German company Qiagen and from a pattern string. The concentration and quality of RNA extracted were measured by adsorption intensity (OD) readings by a spectrophotometer (Nanodrop). SPSS 22 software was used for data analysis and due to the lack of normal distribution of data, Spearman correlation coefficient and Mann-Whitney U test and Kruskal-Wallis tests were used for analysis. Levels less than 0.05 were considered significant.

There was no significant relationship between patients' sex and high expression of the STC2 gene (P = 0.73). The age of 32% of patients was more than 65 years. There was a significant relationship between patients' age and high expression of the STC2 gene (P = 0.031). Most tissue samples were moderate in differentiating cancer (21 cases, 42%). There was no significant relationship between cancer differentiation and high expression of the STC2 gene (P = 0.34). Most patients (18 patients, 36% of them) were in the T3 stage. There was a significant relationship between TNM classification of cancer and high expression of the STC2 gene (P = 0.001). A study entitled clinical significance of stanniocalcin2 expression as a predictor of tumor progression in gastric cancer was conducted in 2013 by Origami et al. In this study, a quantitative PCR test was used to evaluate the expression of STC2 mRNA in 4 gastric cancer cells and the blood samples of 93 patients with gastric cancer and 22 healthy volunteers. They concluded that the number of STC2 mRNA transcripts in gastric cancer cells and the blood of patients with gastric cancer was higher than that of healthy volunteer blood (P = 0.0002 and P = 0.01). STC2 gene expression was positive in 43 patients (46.2%) out of 93 patients with gastric cancer and its expression was significantly related to age, depth of tumor attack, lymph node metastasis, stage invasion and venous (P = 0.023, P = 0.045, P = 0.035, P = 0.007 and P = 0.027). The 5-year survival rate in patients with STC2 expression was significantly lower compared to patients without STC2 expression (P = 0.014). Our results suggest that STC2 by monitoring CTC in patients with gastric cancer can be a useful molecular blood marker for predicting tumor progression (17). The above study is also in line with our study.A study entitled clinical-pathological significance of stanniocalcin2 gene expression in colorectal cancer was conducted in 2017 by Ita et al. In this study, the expression of STC2 and clinical pathology were examined in 139 colorectal cancer specimens using PCR. They concluded that STC2 was more pronounced in colorectal cancer cells than in normal colorectal epithelial cells. The most common anatomical site was gastric trunk cancer and intestinal subtype was seen in most cases. Increased expression of STC2 was observed in 26 patients with gastric cancer (52%) and the control group 8 cases (16%). There was a significant association between high STC2 gene expression and gastric cancer. The present study failed to show a relationship between age, sex, tumor differentiation, anatomical location of gastric cancer, cancer subtypes, and increased STC2 expression. But it showed that there was a significant relationship between the frequency of cases with increased STC2 expression and age over 65 years and TNM classification of cancer.

Our results showed that STC2 in patients with gastric cancer could be a useful molecular blood marker for predicting tumor progression.

Trauma is one of the most common causes of death in the age range 1 to 44 and the third cause of death regardless of age. Abdominal trauma is one of the most common types of trauma. This study aimed to investigate the frequency of causes of laparotomy in penetrating and blunt abdominal traumas in 2016.
This descriptive study was conducted on 120 medical records of patients hospitalized for penetrating and blunt abdominal traumas in Fatemi Hospital, Ardabil, 2016. The inclusion criterion consisted of all patients undergoing laparotomy due to abdominal trauma. In this study, age, gender, education level, type of trauma (blunt or penetrating), results of laparotomy surgery, physical examination and paraclinical findings of patients before operation were collected by a researcher- made checklist.
The results showed that 80% of the patients were male and 35% were in the age range 20-29years. Of patients, 38.3% had penetrating trauma and 61.7% blunt trauma. The most common mechanism of blunt abdominal trauma was car accident (83.8%). Penetrating object was the cause of all penetrating abdominal traumas. Peritoneal stimulation symptoms were observed in 56.5% of penetrating abdominal traumas and 62.2% of blunt abdominal traumas. Hypotension was observed in 21.7% of patients with penetrating abdominal trauma compared with 62.2% in patients with blunt abdominal trauma. The most prevalent damaged organ in patients with blunt trauma was spleen (51.4%). The most prevalent damaged intraabdominal organ was small bowel (17.4%). Negative laparotomy was significantly higher in patients with penetrating trauma than those with blunt trauma (p The results of this study showed that: 1. Road traffic accident and penetrating object were the most common causes of laparotomy in patients with blunt and penetrating trauma respectively; 2. Spleen and small bowel were the most prevalent damaged organs in blunt and penetrating abdominal trauma respectively and; 3. Young males were at highest risk of abdominal traumas.