Assessment of propofol usefulness as an anesthetic agent during colonoscopy

Propofol is used as a sedative drug during colonoscopy. In this study we analyzed the adverse effects of propofol [i.e., hemodynamic and respiratory] on patients who underwent colonoscopies. This study was performed in Qom Province, Iran. In this study, 125 patients [63 females, 62 males] were enrolled. Study patients were administered [0.5-1.5 mg/kg] intravenous propofol by and anesthesiologist. Oxygen saturation and blood pressure were recorded at three minute intervals. We used the American Society of Anesthesiology [ASA] classification to stratify patients by risk prior to the procedure. For statistical analysis, the chi-square and paired t-tests were used. A p-value less than 0.05 was considered significant. Patients' mean age was 45.36 +/- 16.19 years. ASA-I comprised 25.6% of study patients and 74.4% were categorized as ASA-II. Hypopnea occurred in 56.8% of patients and was prolonged in 32.4%. Of the study patients, 5.6% developed hypoxemia which was successfully controlled by the administration of nasal oxygen and no need for mechanical ventilation. The mean arterial blood pressure [p< 0.0001], oxygen saturation [p< 0.0001] and heart rate [p<0.0001] significantly decreased during colonoscopy. The occurrence of hypopnea significantly increased in patients with pre-procedure oxygen saturation levels /= 50 years [p< 0.0001] and ASA class II [p<0.0001] Agitation, hypotension and cough were seen in 1.6%, 1.6% and 0.8% of patients, respectively. Propofol has a short half life that enables faster recovery of normal neurologic and social functions we recommend the use of propofol under supervision of anesthesiologist or a trained gastroenterologist

[Survey the laparoscopic, biochemical and clinical findings in patients with exudative ascites of unknown origin]

Introduction: The etiology of exudative ascites cannot always be diagnosed accurately. Laparoscopy could be used as an appropriate diagnostic modality in these cases

Objective: Evaluate the laparoscopic, biochemical and clinical findings in patients with exudative ascites of unknown etiology

Materials and Methods: In a case-series study, we studied the data of 67 patients with exudative ascites of unknown etiology who under went diagnostic laparoscopy in endoscopy ward of Imam Khomeini Hospital from 2002 to 2005. Demographic data; complaints; clinical, laboratory and laparoscopic findings were evaluated and the accurate etiology of exudative ascites was determined. Man Whitney and Fischer's exact test were used for statistical analysis. P values less than 0.05 was considered significant

Results: The most common cause of exudative ascites was carcinomatous peritonitis then tuberculosis and lymphoma. Tuberculosis peritonitis was the most common etiology of exudative ascites in afghan immigrants. Abdominal masses were only palpated in cases of malignancy. Uniform micronodules and fibrous bands were observed in tuberculous peritonitis. Icter was observed in half of the patients with Budd-chiari Syndrome and lymphoma. Hepatomegaly was mostly seen in Budd-chiari Syndrome and neoplasms

Conclusion: Carcinomatous peritonitis, tuberculosis and lymphoma were the most common causes of exudative ascites of unknown etiology

[Prevalence of hidden prostate carcinoma]

Introduction: Benign prostate hyperplasia [BPH] is the most common benign tumor in males and a major cause of urinary symptoms in most males over 50. Prostate cancer is the second lethal cancer, after lung cancer, in the males

Objective: In attention to the possibility of occurring incidental carcinoma in BPH patients, in this study we decided to estimate its prevalence in urology centers of Rasht hospitals: Razi, Aria and Golsar

Materials and Methods: In this descriptive cross sectional study, from April 2000 through July 2002, we interviewed all patients who later underwent surgery for BPH and filled out the questionnaire form. The reports of the patients were collected from patients and Rasht pathology centers. Data were analyzed by SPSS.9.0 using chi square test, t- test and fisher exact test. P value less than 0.05 was considered significant

Results: From 1437 patients, 39 patients were excluded from study because their pathology reports were not found, and 1398 patients were enrolled. The mean age of patients was 67.8± 7.8 years [43-91]. Prostate carcinoma was detected in 75 patients [5.4%], and all had adenocarcinoma. Mean age of prostate cancer group was 69.4±8.3 years. Fifty patients [66.7%] were smokers. Familial history of prostatic cancer was negative in all patients in cancer group. In patients with diagnosis of cancer, the major symptoms at admission were irritate symptoms [5.3%], irritate obstructive [94.7%] and none of them had only obstructive signs. The grade of tumor in 62.3% was well differentiated and in 37.7% was moderate differentiated. The mean of PSA in cancer and BPH groups were 8.2±12.7 and 2.6±4.1 mg/ml respectively [P= 0.0001] The kind of operation in 53.1% was TURP and in 46.9% was open prostatectomy. In prostate cancer group, 76% of operations were TURP and in 24% were open prostatectomy

Conclusion: In this study, prevalence of prostate cancer in operated patients with a BPH diagnosis was 5.4% that is similar to other studies