Evaluating mortality rate caused by electrolyte abnormalities in hospitalized patients

Adjustment of composition of body fluids and electrolytes is one of the most important aspects of patients care. Sodium and Potassium are the most important body cations, the improper adjustment of them will cause sever disorders in neuromuscular, gastrointestinal, respiratory and cardiovascular systems. Acute renal failure indicated by increase in creatinine and nitrogen urea, brings an accumulation of fluids, salts and metabolites of nitrogen in body. This study intends to assess the status of electrolyte abnormalities and mortality rates of the patients hospitalized in ICU wards in our country. This is a descriptive and retrospective study on the records of 378 patients hospitalized in ICU. A questionnaire was prepared and the data were entered in SPSS system. They were statistically analyzed by using chi-square and fisher's Exact test methods. Out of 378 patients hospitalized in ICU, over 2/3 of them were male and over half of them were>45 years old. Frequency distribution of electrolyte abnormalities was as follows: Hyponatremia 59% hypernatremia 23% hypokalemia 37% hyperkalemia 28%, 35% and 21% of patients had respectively BUN and creatinine more than the normal range. 26% of patients hospitalized in ICU had nonsurgical problems and 74% of the patients had surgical problems. Average time of hospitalization in ICU was 85 days and mortality rate was 35%. The most common electrolyte abnormality was related to variation in serum sodium levels in the form of hyponatremia. And the highest prevalence electrolyte abnormality in dead patients was hyponatremia. This study proves that the prevalence of electrolyte abnormalities is directly related to mortality and increase in hospitalization period and those having undergone surgical operations during hospitalization in ICU, manifested more abnormalities

[ Comparison of the early complications of surgical wounds in two methods of open surgery and laparoscopy in Milad Hospital]

The complications of surgical wounds [esp. wound infections] are considered as a major problem in surgery wards. Complications of surgical wounds are classified as early and late complications. Among the common and early complications are hernatoma, serurna and wound infection. In the recent years, the modern technology especially. Laparoscopic intervention has brought about great developments in general and specific surgical operations. This study was carried out on 210 bedridden patients operated in Milad Hospital during the years 82-84 .The patients were classified into two groups: group A [106 patients] and group B [104 patients] were operated by open surgery and laparoscopy, respectively. The patients were candidate for the two methods on a randmized basis and the statistical test used was proportional test carried out in experimental method and in the from of clinical trial. Out of 210 patients, there were 130 female and 80 male patients. The rates of relative frequency of early complications were 8 and 1 respectively among 106 patients having undergone open surgical operations and 104 patients having undergone laparoscopic operations [P<0.05]. This study proves that there are fewer early complications of surgical wounds under method, tissue damage is smaller so there will be smaller dissection and since vascular damage is smaller, early complications less frequently

[Comparing the early complications of surgical wounds in two methods of open surgery and laparoscopy in Milad Hospital]

Incidence of early wound related complications was assessed in laparoscopic versus open abdominal surgeries. Complications of surgical wounds [esp. wound infections] are considered as a major problem in surgery wards. Complications of surgical wounds are classified as early and late. Common and early complications are hematoma, seruma and wound in fection. Medical records of 104 elective laparoscopic [A] and 106 diagnosis matched open surgeries [B] including appendectomy, cholecystectomy, ventral hernia repair, and bariatric surgery were prospectively reviewed. Study data included patients' sex, age, wound class, type of operation, and occurrence of early wound related complications. Surgical wounds were evaluated for presence of early complications during the post-op period and 10 to 15 days after the operation. The two groups were not different with respect to age, sex and wound classes. No patients in group A and 7 patients in group B developed wound infection. [P<0.05] Incidence of Hematoma was similar in the two groups; one case in each. No patient in the two groups experienced seruma and wound dehiscence. Gender, age and wound classes were not associated with higher rates of wound complications. Laparoscopic surgery significantly reduced the incidence of early wound complications, specially wound infection, and is a safe and effective alternative to conventional open procedures

[Effects of splenectomy on CBC changes in patients with ITP]

ITP is one of the most common cause of thrombocytopenia encountered in medical practice. The disorder has been estimated to affect approximately 1 in 10000 in the general population and to account for 0.18% of the hospital admissions. This study is performed to determine the response of the patients with ITP to splencetomy. This is a descrptive analytical cross-sectional study. The hospital files of 20 patients with ITP who were splenctomized in two university educational hospital were studied during 4 years. The samples were collected by census and one file was excluded because of its deficiency. The data were analyzed by using SPSS software. The mean ITP value was 30928 +/- 14352 SD during the two days before operation versus 476809 + 83252 SD during the two days after it [P=0.000]. The mean ITP value was 476809+83252 SD versus 381432+81265 SD during the two days after the operation and approximately one-year follow up, respectively [P=0.003]. According to our results, splenectomy is a suitable treatment for the patients with ITP. We suggest this procedure to all patients who are indicated in every age, because there is no correlation between its success and the patient's age, his response to previous medical treatments or diagnosis-splencetomy interval