جستجوی مقالات مرتبط با کلیدواژه "بعد جراحی" در نشریات گروه "پزشکی"

Rhinoplasty is one of the most common surgeries performed worldwide. This study aimed to explore the experiences of individuals undergoing rhinoplasty.

This study follows a qualitative descriptive phenomenology design. Participants included individuals who underwent rhinoplasty surgery, selected based on purposive sampling. Data collection continued until data saturation was achieved, resulting in 24 participants. Data analysis was conducted using Colaizzi's seven-step method. Lincoln and Guba's criteria were applied to ensure data validity.

The qualitative analysis identified five main themes, each containing several conceptual categories describing the experiences of patients undergoing rhinoplasty. The main themes included feelings of self-loathing, competition, beauty obsession, psychological disorders, and doubts and regret.

Based on the findings of this study, psychological counseling should be considered in developing guidelines and protocols for cosmetic surgeries by the Ministry of Health or the Association of Cosmetic Surgeons, along with the involvement of a psychologist for approval.

Work-related injuries in surgical technologists cause burnout and poor quality of nursing care. Applying ergonomics can prevent musculoskeletal disorders (MSDs) and reduce work-related stress. Considering the high prevalence of MSDs and job stress in surgical technologists, the present study will aim to determine the effectiveness of ergonomic training interventions based on the PRECEDE-PROCEED model on musculoskeletal disorders and stress in surgical technologists.

This study will be conducted as a randomized controlled trial among surgical technologists working in two hospitals in Yazd in 2024-2025. The surgical technologists of one hospital will be assigned as the intervention group (34 people) and the other hospital as the control group (34 people). The intervention program will be implemented based on the framework of the 8-phase PRECEDE-PROCEED model and the use of ergonomic principles and stress-coping techniques based on the Lazarus interactive model. Data will be collected using the Rapid Entire Body Assessment (REBA), the Nordic Musculoskeletal Questionnaire, the Perceived Stress Scale (PSS-10), and the Behavioral Risk Factors Questionnaire at three stages: baseline, three months, and six months after the intervention. In the control group, data collection will take place in three stages simultaneously with the intervention group, without any intervention. Data were analyzed using independent two-sample t-test and non-parametric Mann-Whitney U test.

Ethical considerations: 

The study protocol has been approved by the Medical Ethics Research Center of Yazd University of Medical Sciences (IR.SSU.SPH.REC.1402.033) and the Iranian Clinical Trial Center (IRCT20230422057974N1).

Maxillary central incisors are very important in regard to function and aesthetics. Early treatment of the impaction of these teeth will lead to higher chance of success and lower rate of complications.

Case report:

 This case report shows the clinical features and periodontal findings of a horizontally impacted maxillary central incisor which is located near the floor of the nasal cavity. The surgical and orthodontic method used for this patient was ultimately very successful in terms of aesthetics and tooth function.

Our results showed that careful monitoring and interdisciplinary collaboration during the treatment phase led to good periodontal health and successful aesthetic results with suitable functional occlusion.

To achieve the least reasonably achievable’ dose of radiation, we have herein introduced a new technique for performing Percutaneous nephrolithotomy (PCNL) under fluoroscopic guidance, named “Low-Fluoro PCNL” (LFPCNL).

PCNL was performed using a standard technique. Modifications in LFPCNL were as follows: Alken guide was replaced on the guidewire and passed into the selected without fluoroscopy.Thereafter, the 30F Amplatz sheath was passed over the dilator without fluoroscopy. To ensure the correct position of the Amplatz sheath, intrarenal saline fluid injection was performed through the ureteral catheter.

LFPCNL was performed in 13 patients (8 males, 5 females) with a mean age of 47.2±15.4 years. The mean fluoroscopy time and mean radiation dose scores were 66.3±40.0 seconds and 24±20 mGy, respectively. No complications occurred in this series of patients.

The present study has introduced the LFPCNL technique as a new, feasible, and safe fluoroscopic-guided PCNL that reduces radiation time. This study had a case series setting and was performed as a feasibility study. This issue is the main limitation of our research; therefore, it is highly recommended to assess the efficacy of our technique in a prospective comparative study with a large sample size

Benign prostate hyperplasia is the most common benign tumor in males. An open prostatectomy procedure can be performed to treat this problem. This procedure can be performed using Pfannenstiel or lower midline incisions. The purpose of this study was to investigate the effect of each of these incisions on the operation time, postoperative pain, intraoperative bleeding, and postoperative scar.

This study was conducted using a randomized clinical trial method on 62 patients who had been referred to Shahid Beheshti Hospital in Hamadan, Iran in 2022 for prostatectomy. Patients were randomly divided into two groups of L (lower midline incision) and P (Pfannenstiel incision). The required data was collected through relevant tools, and the collected data were analyzed using an independent t-test in SPSS software (version 23).

The results showed that there was no significant difference between the L and P groups before studying individual characteristics and the two groups were homogeneous. Based on statistical tests, there was a significant difference between group P and group L regarding the amount of bleeding in the enucleating stage, the amount of pain 24 h after the operation, and the scar score (P<0.05).

The Pfannenstiel incision was considered preferable during the open simple prostatectomy and had less bleeding during the operation, less postoperative pain, and better aesthetic results than the lower midline incision.

Breast cancer is one of the most common types of cancer in women. Locoregional treatment of this disease includes surgery and radiotherapy. Placement of surgical clips to determine the tumor bed is very helpful in radiotherapy planning. It seems that in southwest of Iran, surgeons are less familiar with this issue or have not realized its importance, leading to their insufficient use of this technique. Therefore, our study was conducted to determine the frequency of clips placement in breast cancer patients in this region.

This retrospective study was performed on all women with breast cancer referring to the department of clinical oncology at Golestan Hospital from April 2016 to March 2017. The frequency of clips placement was determined among patients who had undergone breast conserving surgery in this 2-year period. The demographic and clinicopathological data of these patients were reviewed and analyzed.

Out of a total of 1059 patients with breast cancer, 944 (89.14%) underwent breast-conserving surgery, of whom 89 (8.40%) had undergone surgical clips placement. The mean number of clips was 3, and in 58 patients (65.17%) more than 3 clips were placed.

Considering the small number of clipped cases in this region (and probably throughout Iran), it is recommended that training workshops be held for surgeons so that they become more familiar with the importance and necessity of surgical clips placement and its technique.

The clinical skills of surgical technologists, in the role of scrubs and circulars, play an essential role in the success of surgery; Therefore, this study was conducted to examine the clinical skills of orthopedic surgical technologists in the operating room of selected hospitals of Isfahan University of Medical Sciences.

Methods and Materials:

 This study was conducted as a cross-sectional analysis. 26 surgical technologists working in the orthopedic operating room, who met the inclusion criteria, were selected and included in the study through convenient sampling method. Data collection tool was a researcher-made checklist of clinical skills that included 85 items with a 4-point Likert scale (50 questions related to the circular person and 35 questions related to the scrub person).

The average age and work experience of the participants in this study were 29.38 ± 4.95 and 6.42 ± 5.72, respectively. Most of the participants were female (73.1%), most of them had a bachelor’s degree (92.3%) and they were in the workforce (50%). The average clinical skill scores of operating room technologists in the role of circular (in the range of 0-150) and scrub (in the range of 0-105) were 137.27 ±11.24 and 99.69 ± 5.06, respectively. Moreover, they were at the optimal level. The results showed that th average clinical skill scores are more in women than men; however, the t-test did not show a significant difference between the two groups (P=0.56). There is also a significant negative relationship between age and work experience with circular and scrub skills(P<0.001).

The results of this study showed that the orthopedic surgical technologists of selected hospitals in Isfahan have optimal clinical skills in both circular and scrub roles. In addition, there is a significant correlation between factors such as age, gender, and work history and education level with the clinical skills of the personnel. Therefore, it is suggested to plan and implement specialized training courses by respected hospital officials to improve the clinical skills of orthopedic surgical technologists in both circular and scrub roles and achieve an ideal level of skills.

Diabetes is a significant risk factor for postoperative complications and mortality. However, there are different opinions about the relationship between the increase in glycosylated hemoglobin (HbA1c) level and the incidence of surgical complications.

In this retrospective study, 189 diabetic patients referred to Sabalan Hospital in Ardabil who were admitted for surgery were examined in 2021. The data related to demographic information, HbA1c test, postoperative complications, and the outcome of patients’ hospitalization were extracted from the records and entered into the researcher-made checklist. Patients were divided into two groups of uncontrolled diabetes with HbA1c of 7 and above and the controlled diabetes group with HbA1c below 7.

Out of 189 patients included in the study, 97 patients were in the uncontrolled diabetes group, and 92 patients were in the controlled diabetes group. The average age of diabetic patients in uncontrolled and controlled diabetes groups was 58.18±8.91 and 61.84±5.52, respectively. According to the results, surgical site infection and the need for re-surgery during hospitalization showed a significant relationship with an HbA1c level (p≤0.05). Other postoperative complications were not significantly different between the two groups.

It seems logical that elective surgeries should be postponed in HbA1c levels higher than 7% because the presence of high HbA1c levels indicates that the patient’s diabetes is not under control, and as a result, there is a higher probability of chronic complications of diabetes as well as a higher risk for post-operative complications.

Diabetes is a set of metabolic disorders that manifest with increased blood sugar. This is a large pandemic disease that has several hundred million sufferers and a similar number of people at risk, and some people also show a pathophysiology similar to diabetes during injury and severe stress. Diabetic patients require hospitalization and surgery more than other people, and the mutual effects of surgery and diabetes can affect the course of surgery or its complications. Knowing the effects of surgery on diabetes, diabetes and its drugs on surgery and how to manage blood sugar during surgery can be a basis for timely and correct decision making.

One of the constant questions of hospitals and insurance organizations is the actual tariff of global surgeries. This study aims to compare the actual costs of surgeries in the hospitals affiliated to Birjand University of Medical Sciences (BUMS) with the approved global tariffs.

This is a retrospective study that was conducted in 11 hospitals affiliated to BUMS. The study population includes all global surgery bills in 2021. The criterion for entering the study was the presence of sufficient samples (at least 10 bills) from each of the performed global surgeries. Out of 91 collected global surgical procedures, 57 surgical procedures (equivalent to 63% of all global surgical procedures) met the inclusion criteria. The actual costs of surgeries were extracted from the hospital information system and compared with the government-approved tariffs. Data were analyzed using descriptive statistics in Excel 2016 software.

Based on the results, 52% of examined global surgery procedures, the global income was less than the average actual cost, while in 48% of the cases, the hospitals benefited from the costs of surgery. In 56 surgery cases, the billing cost was 12-139% higher than the approved global tariff, and in 23 cases, the difference was more than 50%.

There is a considerable difference between the actual cost of global surgeries in hospitals affiliated to BUMS and the approved tariffs. Due to the higher actual cost of surgeries, these tariffs have resulted in losses in hospitals.

Patients who have nephrolithiasis and are candidates for operation may have symptomatic or asymptomatic bacteriuria, which should be treated before any surgical intervention. We evaluated our patients for the prevalence of bacteriuria before surgical intervention.

Between March 2020 and March 2022, a total of 832 patients (489 men and 343 women) with a mean age of 38.4 years, who were candidates for renal stone surgery, were evaluated by tests, including complete blood count, urine analysis, and preoperative culture. In this study, we recorded the bacteriuria (symptomatic or asymptomatic).

Of 832 patients, 594 had the first episode of stone formation and 238 had recurrent diseases. Of these, 784 patients were scheduled for percutaneous nephrolithotomy and 48 patients for open nephrolithotomy. Overall, in the preoperative urine analysis test, 56 cases of bacteriuria were reported, of which 22 cases had positive urine cultures. Of the positive culture cases, 14 were recurrent and 8 were patients who had kidney stones for the first time. The most common microorganism was Escherichia coli (n=15), followed by Klebsiella (n=4), Proteus (n=2), and Pseudomonas (n=1). Only 8 of these patients had symptoms and the rest were asymptomatic. All of these patients received a course of oral antibiotics before the operation.

Bacteriuria is a common finding in patients with nephrolithiasis that seems to be more common in recurrent diseases; therefore, urine culture and appropriate treatment are mandatory before any intervention to prevent serious complications, such as infection, sepsis, and mortality.

Surgical correction of hypospadias is one of the most common pediatric surgeries. Due to the several methods of hypospadias operations, the evaluation of results has always been challenging. Several questionnaires have been designed to reduce the discrepancy in the reports of hypospadias surgery, and the HOPE questionnaire is one of the most common. Based on our search, the reliability and validity of the Persian version of the HOPE (Hypospadias Objective Penile Evaluation) questionnaire have not been assessed yet.

In this cross-sectional study, firstly, the questionnaire "Objective evaluation of penis in hypospadias" was translated by two urologists and an English language expert familiar with medical concepts according to the Backward-Forward translation method into Persian and then again into English, and finally, the questionnaire was sent to experts and compared with the original questionnaire. The quality of translation and content were finalized and corrected. Thereafter, in order to check the form and content validity, the questionnaire was sent to eight experts, and the content validity indices and its content validity ratio were calculated. In order to check the reliability-stability of the re-test, two questionnaires, including images after hypospadias surgery of 42 patients, were delivered to eight specialists in pediatrics, urology, and pediatric surgery to determine the score at a time interval of one week, and finally, the data were analyzed in SPSS software (version 23) using the test-retest method. The Intraclass Correlation Coefficient (ICC) index and its confidence interval were calculated by the scores obtained from twice answering the instrument for each factor and the entire questionnaire. In order to determine internal consistency and reliability, Cronbach's alpha coefficient was calculated for each factor and the entire questionnaire.

In our study, intraclass correlation coefficient values for inter-rater reliability in the HOPE score were calculated at 0.89, indicating the high reliability of this questionnaire in Persian. The internal consistency of the Persian version of the HOPE scale was confirmed, rendering a Cronbach's alpha coefficient of 0.98.

The good validity and reliability of the HOPE scoring system in Persian support its use as a standard objective outcome measure of the cosmetic result after hypospadias surgery.

Preventing the cancellation of surgeries is an important and devastating challenge in operating room management. Cancellation of pre-scheduled surgeries at the last moment in the operation room leads to increased length of stay, patient dissatisfaction, human resource consumption and financial burden for patients and the health care system. In this study, we have investigated the effect of recording the causes of surgery cancellations in the operation room on the incidence of surgery cancellations in patients who have been candidates for non-emergent surgeries.

A total of 545 surgeries which had been canceled in different types of surgery between March 2014 and March 2015 were recorded according to the reasons for cancellation in predetermined forms and the information was analyzed. The most common reasons for cancellation included changing the plan of treatment from surgery, a high-risk comorbidity with a high probability of mortality, patient’s refusal from surgery, an unanticipated duration of previous surgery longer than anticipated, the unavailability of an ICU bed in the hospital, requested laboratory data not being ready, failing to prepare requested packed RBCs and other hospital or patient-related problems.

The percentage of surgery cancellations in most groups including orthopedics, urology, cardiac surgery, general surgery, gynecology and maxillofacial surgery, decreased during the course of this study. According to our findings the most relevant cause of non-emergent surgery cancellation was the unpredictable increased duration of previous surgery. The maxillofacial surgery group reached the highest surgery cancellation reduction rate and the cardiovascular surgery group experienced the lowest cancellation reduction rate. Also, the percentage of surgery cancellations in the field of neurosurgery increased during the study period.

Recording the reasons mentioned by the surgical team as the reason for canceling surgeries and reducing the rate of their occurrence during the study and providing appropriate feedback and dialogue in this case had a positive effect on reducing the rate of cancellation of the surgeries and reducing the mentioned reasons.

Ectopic pregnancy is a relatively common problem in women of reproductive age. This study was conducted with the aim of investigating the relationship between each of the treatment methods performed among women with a history of EP with their future fertility.

This cross-sectional study was conducted in 2020. A total of 207 patients who were diagnosed with EP in Al-Zahra and Shahid Beheshti hospitals in Isfahan between 2016 and 2018 were included in the study. Demographic characteristics as well as the data about the type of treatment (pharmacological treatment, radical surgery and conservative surgery) that were performed for the patients with previous EP were extracted from their health files. Then, during a phone call with the patients, they were asked about their fertility status after the treatment, then the fertility results of these people in different treatment groups were investigated and compared.

This study showed that women with past history of EP who were treated with medication had significantly more successful pregnancies than the surgical group. While the comparison between two types of radical and conservative surgical methods did not show a significant difference in pregnancy success.

Successful pregnancy was seen more in patients with previous EP who were treated with medications compared to those who underwent surgery. According to this study, radical and conservative surgery methods had no effect on the success of the next pregnancy.

Acute pain after arthroplasty of the lower limb has adverse effects on the patient&#039;s treatment aspects, and also considering that acute pain (within the first 24 hours) after surgery is the basis of chronic pain and disability after surgery. and on the other hand, due to the lack of a meta-analysis study regarding the effects of pregabalin on the intensity of acute pain after lower limb surgeries, the present study aimed at the preventive effects of pregabalin on the intensity of acute pain during the first 24 hours after orthopedic surgeries The bottom is done.

This meta-analysis was performed following the guidelines of the PRISMA statement; Studies were selected based on the PICO criteria. Keywords pain, pain intensity, acute pain, pregabalin, lower limb, lower limb orthopedics and analgesia were searched in PubMed, EMBASE and Cochrane Library, Web of Science, Scopus, Mag Iran and SID databases; Statistical analyzes were performed using RevMan 5.4 software.

Pain intensity in the second (MD = -0.26 - CI95% = -0.02 to -0.50 and P = 0.04) and sixth (MD = -0.30 -CI95% = -0.29 to -0.30 and P = 0.00001) and the twelfth (MD = -0.53 -CI95% = -0.29
to -0.78 and P = 0.0001) after surgery was significantly lower in the intervention group than in the control group.

This meta-analysis supports the use of pregabalin before surgery in patients undergoing lower extremity orthopedic surgery and by reducing the intensity of acute pain (pain during the first 12 hours after surgery).

Any type of tumor is considered as an insidious risk to life, and its early diagnosis can be effective in the treatment and recovery process. Several factors challenge the early diagnosis of brain tumors. Since psychiatric symptoms do not reflect the pathogenomic characteristics of brain tumors, the underlying organic cause may be overlooked. The present study was conducted with the aim of determining mood and sleep disorders in patients with central nervous system hemangioblastoma after surgery.

This descriptive-cross-sectional study included 32 patients with hemangioblastoma who underwent surgical treatment between 2016 and 2016. Patient information was collected by checklists and standard questionnaires. Karnofsky's and ECOG functional status scales, Brunel's mood scale and short sleep questionnaire MSQ were used to evaluate the performance status.

The age of the patients was 44.28±15.15 years and 18 (56.3%) were male. The follow-up time of the patients was 6.71±3.57 years. Also, the average tumor size was 35.4±12.98 mm. 9 patients (28.1%) underwent radiotherapy in addition to surgery and 5 patients (15.6%) underwent chemotherapy. Functional status of Karnofsky and ECOG was optimal. Sleep disorders indicate moderate sleep and wakefulness problems, and all dimensions of mood disorders (tension, depression, anger, fatigue, vitality, and confusion) were more than average.

In the present study, as in other studies, depression and tension were important mood factors in brain tumor patients. In addition, they had a significant impact on the patients' functional status. In this regard, it is suggested to conduct more detailed and comprehensive studies on the psychological disorders of patients with any type of brain tumor and to consider psychological treatments as part of the treatment process for these patients.

Hand disinfection methods are not germ-free, and infected hands transmit the infection. One of the personal protective equipment of the operating room is the mask, which will probably be contaminated by the hands when removing the mask. The aim of this study is to determine the effect of using automatic mask dispenser on the contamination of surgical masks in the operating room.

Methods & Materials:

 The present study is a field experiment that was conducted on 120 hospital staff in Isfahan in 2021. The subjects were randomly divided into two groups of 60; automatic device and manual mask removal. The effect of contact of hands impregnated with fluorescent powder was measured during the removal of the mask in each group. The contamination area of ​​the removed mask and the lower mask on the back and front surfaces were compared in the two groups.

The Mann-Whitney test showed that there was a significant difference in the area impregnated with fluorescent powder from hand contact with the mask surface between the two methods (P<0.05). Only 125.6±77.8 mm2 of from the front surface and 30.6±26.0 mm2 from the back surface of the mask removed with the automatic mask dispenser were contaminated, while the ratio in the hand-removed mask was respectively 961.6±612.9 and 440.4±315.6 mm2.

The study showed that eliminating hand contact with the body of the mask using an automatic mask dispenser, can reduce its contamination. Therefore, mechanization of services is effective in ensuring the safety of individuals’ health and reducing costs.

Clinical education is one of the most important educational topics in the fields of medical sciences, especially nursing, midwifery and surgical technology, which is effective in both students' clinical performance and their future careers. Due to the importance of the quality of clinical education in this study. The aim of this study was to investigate the factors affecting the quality of clinical education and related factors from the perspective of students of the School of Nursing and Midwifery of Kurdistan University of Medical Sciences.

This descriptive-analytical cross-sectional study was conducted with the participation of 250 students of the School of Nursing and Midwifery of Kurdistan University of Medical Sciences in 2019 and 2020 by census method. In order to collect information from the demographic questionnaire and the questionnaire to assess the factors affecting the quality of clinical education, it was taken from the study of Ghorbanian and colleagues. After completing the sampling, the data was analyzed using SPSS version 22 software and descriptive and inferential statistics .

Based on the results of the analysis, 158 (63.2%) participants were female. Most of the students were 135 (54%) nursing students and most of them were in the 6th semester (22.8%). From the students' point of view, the educational goals and program with an average and standard deviation of 22.74 ± 3.12 were among the educational strengths. In the field of dealing with students, the mean and standard deviation was 7.544 ± 1.541. Based on the results of the analysis, there was no relationship between age,gender and place of residence the areas under evaluation (p> 0.05), but there was a relationship between students' with the areas of objectives and curriculum, student treatment, learning environment, monitoring and evaluation, and self-efficacy.

The quality of clinical education from the perspective of students in all fields of nursing and midwifery of Kurdistan University of Medical Sciences is acceptable. However, in order to improve the weak points in order to improve the quality of clinical education, attention should be paid to the demographic characteristics of students as well as the different aspects of the quality of clinical education.

Nosocomial infections are one of the world's health problems, and operating room personnel play a very important role in its prevention. Therefore, this study was conducted to determinate the performance of surgical technologists in infection control and related factors in Sanandaj teaching and medical hospital.

This descriptive-analytical and cross-sectional study was conducted with a sample size of 100 people using available methods in educational and medical centers in Sanandaj. Data collection was done with a demographic questionnaire and the rate of application of infection control principles. Then the data was used using SPSS 22 software and descriptive statistics and chi-square test.

According to the results 56% of the participants were female, 66% were less than 40 years old, and 66% had an operating room bachelor's degree. The performance of 98% of the surgical technologists was good and acceptable, and among the dimensions, the highest scores were obtained for pre-operative activities and the lowest for post-operative activities. There was no significant relationship between the performance status and the application of infection control principles with age, sex, education degree, work experience and working hours (p>0.05).

In this research, the performance of surgical technologists was at an acceptable level, but there were defects in some functions such as changing masks and wearing gloves in a closed manner, which can be corrected by holding training classes.