Evaluation of the effect of anti-biotherapy following surgery of acute supurative appendicitis, on some infection indicators

Prophylactic anti-biotherapy in acute appendicitis is necessary to prevent peritonitis and gangrene of appendix. But anti-biotherapy in the first 24 hours after appendectomy in acute supurative cases requires further investigations. The aim of this study was to evaluate the effect of anti-biotherapy on prevention of the complications of the surgery and duration of hospitalization. This is a prospective blind clinical trial study from 1379 to 1382 in 3 university hospitals in AHWAZ including all the cases of supurative appendicitis. In this study 200 patients were divided into two equal groups. In one group cefazolin and metronidazole were prescribed for the purpose of prophylaxis before surgery and in the other group, in addition to prophylactic anti-biotherapy, cefazolin and metronidazol continued for another 24h after surgery. Then the patients were followed up for 2 months to be examined for wound infection, abdominal and pelvic abscesses, wound dehiscence and duration of hospitalization. In this study, 200 patients 56% male and 44% female were divided into two equal groups. Mean age of the patients was 18.5 years [15-40]. The first group received antibiotics for 24h after operation. But wound infection and post operative fever were detected in 4% and 6% of these patients respectively and mean days of hospitalization was 2.6 days [2-7 days]. In the second group without post operative anti-biotherapy incidence rate of wound infection and post operative fever were 4% and 8% respectively and the mean days of hospitalization was 2.8 days [2-7 days]. There were no abdominal or pelvic abscess and wound dehiscence in both groups. In this study incidence of wound infection [p=1.00] and post operative fever [p=0.58] and mean days of hospitalization [p=0.68] were similar in both groups and there were no significant statistical differences. It seems that post operative anti-biotherapy in supurative appendicitis is of no value in reducing the incidence of wound infection, post operative fever and mean number of days of hospitalization

Prevalence of malignancy in thyroid nodules in referral patients to Imam Khomeini Hospital during 1370-1379

Thyroid nodule is a risk factor in thyroid carcinoma. So proper awareness, evaluation and appropriate management of these nodules can result in early diagnosis and treatment of thyroid cancer which can lead to better prognosis. In this study we evaluated 100 patients with thyroid nodules who referred to Imam khomeini hospital of Ahvaz during 1370-79. Findings showed that 18% of the subjects were diagnosed as thyroid cancer after operation and 89% were those who had solitary and cold nodule. It is believed that medical suppression therapy is a treatment of choice in these patients but we believe this can induce delay in diagnosis and appropriate treatment. So, lobectomy and isthmectomy appear to be the management of choice in thyroid nodules especially in solitary and cold nodule in males