Comparison of surgical site infections between laparoscopic and open cholecystectomy

Background: This study assessed the causes of infection in cholecystectomy and compared the infection rates between the open and laparoscopic cholecystectomy

Materials and Methods: This was a retrospective cohort study, performed on all patients admitted to Shariati Hospital since February 2017 for cholecystectomy. Initially, the patients were evaluated for infection risk factors, and then surgical site infection rates in these individuals were measured. Infection was assessed at the time of patients discharge [in the first few days after surgery] and again a month later, either in clinic or by phone. Information from 81 patients was collected, and SPSS software version 24 was used to analyse the data using appropriate statistical tests. Statistical significance was defined as p value < 0.05

Results: The mean age of the participants was 45.89 +/- 13.38. The relationship between surgical site infections [SSI] and age, sex, comorbidities [diabetes, hypertension, ischemic heart disease, malignancy, chronic lung disease, and chronic kidney disease], taking corticosteroids, smoking, and the emergency or elective nature of the surgery was not significant. The mean age of the patients who underwent open cholecystectomy was higher than the laparoscopic group [p = 0.005]. Similarly, the average hospitalization period for those underwent open cholecystectomy was higher [p = 0.03]. Finally, the infection rates for open cholecystectomy were 6 times higher than laparoscopic surgeries [RR: 6.11]

Conclusion: There was no significant relationship between SSIs and the risk factors assessed in this study. However, infection rates were higher in the open cholecystectomy group. More studies on the various risk factors of infection and the differences between the laparoscopic and open surgical methods are required

Effects of aqueous extract from Asparagus officinalis L. roots on hypothalamic-pituitary-gonadal axis hormone levels and the number of ovarian follicles in adult rats

Background: Asparagus is a plant with high nutritional, pharmaceutical, and industrial values

Objective:The present study aimed to evaluate the effect of aqueous extract of asparagus roots on the hypothalamic-pituitary-gonadal axis hormones and oogenesis in female rats

Materials and Methods:In this experimental study, 40 adult female Wistar rats were divided into five groups, which consist 8 rats. Groups included control, sham and three experimental groups receiving different doses [100, 200, 400 mg/kg/bw] of aqueous extract of asparagus roots. All dosages were administered orally for 28 days. Blood samples were taken from rats to evaluate serum levels of Gonadotropin releasing hormone [GnRH], follicular stimulating hormone [FSH], Luteinal hormone [LH], estrogen, and progesterone hormones. The ovaries were removed, weighted, sectioned, and studied by light microscope

Results: Dose-dependent aqueous extract of asparagus roots significantly increased serum levels of GnRH, FSH, LH, estrogen, and progestin hormones compared to control and sham groups. Increase in number of ovarian follicles and corpus luteum in groups treated with asparagus root extract was also observed [p<0.05]

Conclusion:Asparagus roots extract stimulates secretion of hypothalamic- pituitary- gonadal axis hormones. This also positively affects oogenesis in female rats

Frequency of antitoxocara antibodies in students with chronic cough and eosinophilia in a rural area of Shiraz, Iran

Visceral larva migrant's syndrome by toxocara affects mainly children between 2 and 5 years old, it is generally asymptomatic, and the seroprevalence varies from 3 to 86% in different countries; as well as, the secondary stage larvae cause ocular, respiratory and neurotic disorders. The aim of this study was to determine the incidence of anti-toxocara antibodies in children blood that showed chronic cough having eosinophilia in rural part of Shiraz, Iran. In a cross sectional study during a tuberculin survey rural area of Shiraz, a city in Southwest Iran, a number of 610 children were selected by randomized two-stage cluster sampling. Children with chronic cough were investigated for toxocariasis. Initially, the absolute eosinophil count was determined. Then, children having eosinophilia were tested by toxocara-IgG - ELISA kit [Ibl, Hamburg]. Of total 80 children with chronic cough, 12 [15%] were eosinophilic, among them 6.25% were hypereosinophilic, 9 [11.25%] were toxocara ELISA-IgG positive. No correlation between intestinal parasites and toxocariasis was detected. There was also no significant interdependence between age, gender, and dwelling difference in toxocara antibody amount. Presence of eosinophilia and the risk factors evaluated in this population were frequently associated to human toxocariasis. Anti toxocara antibody was detected in more than half of children with chronic cough, thus, toxocariasis among children in schools should have been noticed in schools by both education and hygiene ministry

Peripheral lymphadenopathy: approach and diagnostic tools

Peripheral lymph nodes, located deep in the subcutaneous tissue, clean antigens from the extracellular fluid. Generally, a normal sized lymph node is less than one cm in diameter. Peripheral lymphadenopathy [LAP] is frequently due to a local or systemic, benign, self-limited, infectious disease. However, it could be a manifestation of underlying malignancy. Seventy-five percent of all LAPs are localized, with more than 50% being seen in the head and neck area. LAP may be localized or generalized. Cervical lymph nodes are involved more often than the other lymphatic regions. Generally, it is due to infections, but most of the supraclavicular lymphadenopathies are associated with malignancy. Based on different geographical areas, the etiology is various. For example, in tropical areas, tuberculosis [TB] is a main benign cause of LAP in adults and children. Complete history taking and physical examination are mandatory for diagnosis; however, laboratory tests, imaging diagnostic methods, and tissue samplings are the next steps. Tissue diagnosis by fine needle aspiration biopsy or excisional biopsy is the gold standard evaluation for LAP. We concluded that in patients with peripheral LAP, the patient's age and environmental exposures along with a careful history taking and physical examination can help the physician to request step by step further work-up when required, including laboratory tests, imaging modalities, and tissue diagnosis, to reach an appropriate diagnosis

effect of word meaning on speech dysfluency in adults with developmental stuttering

Stuttering is one of the most prevalent speech and language disorders. Symptomology of stuttering has been surveyed from different aspects such as biological, developmental, environmental, emotional, learning and linguistic. Previous researches in English-speaking people have suggested that some linguistic features such as word meanings may play a role in the frequency of speech non-fluency in people who stutter. The aim of this study was to determine the effect of word meanings on the frequency of dysfluency in Persian-speaking adults with developmental stuttering. This cross-sectional descriptive-analytic study was performed on 14 adults who stuttered. Their average age was 25 years. The frequency of non-fluency instances was evaluated upon reading two lists containing 60 words and 60 non-words. The words were selected on the basis of common Persian syllable structures. 'Kolmogoro-Smirnov one sample test' and paired t-test was used to analyze data; the significance level was set at P < 0.05. There was a significant difference between the dysfluency in word and non-word lists [p < 0.05]. The findings of this study indicate a significant increase in the frequency of dysfluency on non-words than on real words. It seems that the phonological encoding process of non-word reading is much more complex than for word reading, because, in non-word reading, the component of semantic content retrieval [word meaning] is missing when compared to word reading

Oxford-MEST classification in IgA nephropathy patients: a report from Iran

There is a limited knowledge about the morphological features of IgA nephropathy [IgAN]in the middle east region. The objective of this study was to evaluate the spectrum of histopathological findings in IgAN patients at our laboratory. At this work, an observational study reported which was conducted on IgAN patients using the Oxford-MEST classification system. In this survey, of 102 patients 71.6% were male. The mean age of the patients was 37.7 +/- 13.6 years. Morphologic variables of MEST classification was as follows; M1: 90.2%, E: 32%, S: 67% also, T in grads I and II were in 30% and 19% respectively, while 51% were in grade zero. A significant difference was observed in segmental glomerulosclerosis [P=0.003] and interstitial fibrosis/tubular atrophy frequency distribution [P=0.045], between males and females. Furthermore, it was found that mesangial hypercellularity was more prevalent in yonger patients. Moreover, there was a significant correlation between serum creatinine and crescents [P<0.001]. There was also significant correlation of serum creatinine with segmental glomerulosclerosis [P<0.001]. Higher prevalence of segmental glomerulosclerosis and interstitial fibrosis/tubular atrophy, as the two of, four variables of Oxford-MEST classification of IgAN in male patients further attests that male gender is a risk factor in this disease. In this study the significant correlation between serum creatinine and crescent was in an agreement with previous studies and suggests for the probable accomodation of extracapillary proliferation as a new variable in MEST system

Alterations in antibiotic susceptibility of urinary tract infection pathogens

Urinary tract infection [UTI] is the third most common infection in human. New resisted strains of uropathogens have been developed due to different factors such as widespread use of antibiothics. We conducted this study to assess the recent pattern and susceptibility of uropathogens. This descriptive cross-sectional study was carried on 32600 ambulatory patients' urine samples from six laboratories from 2008 to 2010 in Ahvaz, Khuzestan. Of those, 3000 positive culture were found. Data including underlying disease, pregnancy, catheterization and drug history were gathered by questionnaire. Susceptibility of pathogens to eight antimicrobial agents was determined. Mean age of patients was 33.87 +/- 3.80 years and 84.9% of them were female. The results showed that, E. coli, Kelebsiella and Enterobacter were the most common pathogens [73.5%, 13.8% and 6.6%, respectively]. E. coli was susceptible to Ciprofloxacin, Amikacin, and Nitrofurantoin in 76.9%, 76.4% and 76.1% of cases, respectively. Klebsiella was more susceptible to Ciprofloxacin, Ceftizoxim and Amikacin in 81.1%, 79.9% and 87.7% of positive cultures. Enterobacter was most susceptible to Ciprofloxacin [71.7%], but completely resistant to Ampicillin unexpectedly. E. coli and other isolates were more sensitive to Gentamicin, Amikacin and Ciprofloxacin compared to the other antibiotics tested and therefore these may be the drugs of choice for the empiric treatment of community-acquired UTI in our region

[Intonation and duration curve in Persian interrogative sentences]

Prosody is a very important factor in communication and includes such parameters as: duration, intonation, pitch, stress, rhythm etc. Intonation is the pitch variation in one sentence. Duration is the time taken to utter a voice. The aim of the present study was to evaluate some parameters of prosody such as duration and intonation curve in interrogative sentences among normal Farsi speaking adults in order to determine the characteristics of this aspect of language with an emphasis on laboratory testing. This study was performed as a cross-sectional one. The participants included 134 male and female Farsi speaking individuals aging between 18-30 years. In this study two interrogative sentences with open and closed answers were used. The voice samples were analyzed by Dr. speech -real analysis software. Data analysis incorporated unilateral analysis of variance and an intonation curve was drawn for each sentence. The parameter of duration among men and women was significantly different [p

[Comparing of two Farsi passages in laboratory evaluation of mean and fundamental frequency variations range]

Voice disorders assess with the help of laboratory equipments and perceptual evaluation. Voice samples involve vowel prolongation, text-reading or conversational speech. In Iran, Rainbow text and Grandfather text, were developed for assessing voice. This study was cross-sectional and descriptive-analytical. Mean and fundamental frequency variations range in 120 normal males and females aging from 20-59 years old were studied. Voice samples of reading both texts were gathered and compared. Mean fundamental frequency in males in Grandfather text was 137.93 with SD 1.2 and in Rainbow text was 135.09 with SD 1.1 [p>0.05], in females Grandfather and Rainbow texts were 206.07 with SD 0.9 and 204.23 with SD 2.1, respectively [p>0.05]. Fundamental frequency variations range in Grandfather text in males was 88.10 with SD 0.8 and in females was 116.77 with SD 1.3 and in Rainbow text in males was 90.92 with SD 1.1, in females was 116.08 with SD 1.2 [p>0.05]. Mean fundamental frequency of males in each text didn't show significant difference in age groups and just in 50-59 age group of the female population showed significant difference. Fundamental frequency variations range didn't show significant difference in males and females in both texts. These two texts were the same in measurement of average and fundamental frequency variations range in adults. Significant difference showed between 50-59 age group of the female population and other groups

[Developing and studying of the voice disorder symptoms questionnaire in adults]

Evaluation of voice problem involves perceptual, acoustic, aerodynamic and physiological measure. In recent years assessment of patients point of view use as a essential part of evaluation. The aim of this study was construct a questionnaire for assessment of physical, functional and emotional voice problems in adults. This study is a kind of constructing battery. Based on a comprehensive study of many foreign questionnaires, "The voice symptoms assessment" questionnaire in adult was produced. Its content validity was determined according to the judgment of 7 speech and language pathologists. This questionnaire administered to 60 voice patients [20 female and 40 male] between 18 to 60 years old that could read and write in Persian. The reliability of this questionnaire is determined by the method of Cronbach Alpha and split half. Content validity index of this questionnaire was 0.94. Cronbach Alpha was high [more than 0.7] and Spearman-Brown coefficient of split half was 0.96. Correlatoin Coefficient was statistically significant between 3 parts and total questionnaire [p<0.01]. "The voice symptoms assessment" questionnaire in adult has good content validity and reliability and reflects the wide range of physical, functional and emotional problems in voice patients. This questionnaire is simple for patients to complete and easy to score. It seems that use of this questionnaire, as part of a complete voice evaluation will be helpful in future.

[Evaluation of semantic aspect of language in students of ordinary, integrated and special schools]

Children with severe and profound hearing loss have difficulties in communicating with others and educating at school. Effects of learning environment on children's language skills have been recently focused and educating those students in ordinary schools has been proposed. According to this view, we compared perception of antonyms and synonyms as a semantic aspect of language in students of ordinary, integrated and special schools. It was an analytic cross-sectional study. Three groups of students were enrolled: normal hearing students of ordinary schools and hearing-loss students of integrated and specials schools. Each group consisted of 25 students in fifth grade of elementary schools in Tehran city. Two written tests were used. Subjects wrote synonyms and antonyms for each word in the tests. Results denoted significant differences between scores of normal-hearing and hearing-loss students and also between hearing-loss students of integrated schools and hearing-loss students of special schools [p<0.05]. In all three groups of the students, perception of antonyms was better than antonyms [p<0.001]. Speech processing rate in normal-hearing students were higher than both groups of hearing-loss students [p<0.001]. The differences between normal-hearing and hearing-loss students shows that similar to other language skills, perception of synonyms and antonyms as a semantic aspect of speech is related to the hearing conditions and type of education. Moreover, the differences between two groups of hearing-loss students represent that speech stimulants and interaction with normal-hearing children could improve semantic aspect of speech in hearing-loss students.

[Development of picture verb test for 36-54 month-old normal Persian-speaking children and determination of its validity and reliability]

Verb is one of the most important aspects of a sentence, and verb deficit is a noticeable part of developmental language disorders. In Iran, there is no standard test for evaluating this aspect of language in children. This study aimed to develop and evaluate a picture verb test for 36- 54 month-old normal Persian-speaking children, and assess its ability to differentiate between children. A list of verbs that could be depicted was collected and content validity was assessed by seven speech therapist. 55 verbs were selected. Then, three pictures were prepared for each verb and one of those pictures was chosen by the same seven specialists. 106 children aged 36-54 months participated in this study. They were divided into three groups [36-42, 42-48, and 48-54 months]. Reliability of this test was assessed by Spearman's correlation and internal consistency. Correlation between children's scores and their age was calculated. Content validity index of all verbs were 1. Spearman's correlation of 0.89 and internal consistency of 0.60 was obtained. By deletion of item method, the Kuder-Richardson score was enhanced to 0.71. There was a significant correlation between children's ability to respond and their age [r=0.76, p < 0.001]. This test is a suitable tool for assessment of verbs in 36-54 month-old Persian-speaking children and can differentiate between three groups under study

association between selected RANKL gene polymorphisms and chronic/aggressive periodontitis in Iranian subjects

The primary aim of this study was to investigate the status of RANKL6-7 gene polymorphism in patients with chronic [mild, moderate, severe] and aggressive periodontitis as well as healthy controls. We examined 80 patients for the RANKL6-7 polymorphisms [rs1054016 and rs9567000]. Polymorphism was determined by polymerase chain reaction [PCR] followed by direct sequencing. No statistically significant association was found between the polymorphism in the RANKL 7 gene and periodontal disease [P<0.55]. There was also no polymorphic allele observed in RANKL 6 gene of the study population. We found no association between the studied RANKL polymorphisms and chronic/aggressive periodontitis

proposed grading system for post-intubation tracheal stenosis

Tracheal stenosis is still a serious consequence of endotracheal intubation. Previous classification systems are commonly descriptive and are not intended to deal with management approach. The aim of this study was to present a classification system for post intubation tracheal stenosis and evaluate its efficacy in distinguishing critically ill patients who need surgical intervention. This classification system was developed based on size and type of stenosis and associated clinical signs and symptoms. Stenosis was graded based on the results of clinical examination and rigid bronchoscopy. All patients received surgical or conservative treatment based on the judgment of a surgeon experienced in management of post-intubation tracheal stenosis without considering their score. ROC curve analysis was done and cut-off point was established based on the greatest Youden index. Sixty patients were studied. Resection and anastomosis were done for 49 patients. The mean score for all samples was 9.18 [range 8.77-9.45]. Chosen cutoff point was 8.5 and calculated sensitivity and specificity were 89% and 42%, respectively. Positive and negative predictive values were 83.7% and 54.5%, respectively. A reasonable agreement between the estimated score and surgeon's clinical judgment [kappa=0.78] was observed. A statistically significant relationship was observed between scores greater than 8.5 and need for surgical intervention [P= 0.007]. We presented a scoring system for post-intubation and tracheostomy tracheal stenosis using main factors influencing diagnosis and treatment and its efficacy was evaluated prospectively. It seems that this system would be capable of assimilating the treatment interventions and comparing them

Effects of grape seed proanthocyanidin extract on oxidative stress induced by diabetes in rat kidney

This study examined the effect of grape seed proanthocyanidin extract [GSPE] on lipid peroxidation content and activity of tissue antioxidant enzymes, including catalase, superoxide dismutase and glutathione peroxidase in diabetic rats. Thirty male rats were divided into three groups of 10 rats each: control, diabetic and diabetic groups that received 500 mg/kg GSPE for 6 weeks. Diabetes was induced by a single intraperitoneal injection of streptozotocin [50 mg/kg body weight]. Rats with fasting blood glucose levels above 250 mg/dl were used as diabetic animals. The first 24-hour urinary albumin excretion [UAE] was measured two weeks after diabetes induction and then each week until the end of the experimental period in all groups. Lipid peroxidation content and activities of catalase, superoxide dismutase and glutathione peroxidase were measured in kidney homogenate supernatants. Statistical significance of differences was assessed with one-way ANOVA by SPSS followed by Tukey's t-test. P <0.05 was assumed statistically significant. UAE in diabetic nephropathy rats were significantly higher than in control. In addition, an increase in lipid peroxidation content and decrease in catalase, superoxide dismutase and glutathione peroxidase activities in kidney of diabetic nephropathy rats were observed. The GSPE administration did not affect on body weight, but significantly decreased lipid peroxidation and augmented the activities of antioxidant enzymes studied in kidney of diabetic nephropathy rats as well as reduced UAE and decreased kidney weight. The results suggested that GSPE could ameliorate diabetic nephropathy rats through reduction of oxidative stress and increase in renal antioxidant enzyme activity

[Effects of voice therapy on vocal acoustic characteristics in patients with vocal cord nodules]

Vocal cord nodule is one of the voice disorders causes hoarseness and breathy voice. Voice therapy is one of the treatment approaches. We aimed to find out the effects of voice therapy on vocal acoustic characteristics in these patients. In this case series, five women with vocal nodule [14 to 45-year-old] participated in a 9- week voice therapy program developed by Boone. Vocal hygiene and voice practices were measured every day using a questionnaire. Moreover, structure and movements of vocal folds were examined using videolaryngostroboscope by a laryngologist before and after voice therapy to evaluate the effectiveness of program. For collecting voice samples we used sustained /‘/ in comfortable loudness for all patients and data were analyzed using Speech Studio. After voice therapy, fundamental frequency in four of five subjects were decreased but it was not significant [p=0.225]. However, jitter in all of five subjects was significantly decreased [p=0.043]. After voice therapy, shimmer in three of five subjects were decreased that was not significant [p=0.345]. Voice therapy can be used for the remedy of acoustic vocal characteristics and elimination or contraction of vocal cord nodule

[Sentence writing and perception of written sentences in hearing-impaired and normal-hearing primary school students in Hamadan, western Iran]

Learning language is acquired in early childhood and gradually developed by new words and new structures. Hearing sense is the most important acquisition for learning this skill. Hearing disorders are barriers for natural language learning. The purpose of this study was to investigate the relationship between writing sentences and perception of written sentences in hearing-impaired and normal-hearing students. A cross- sectional study was conducted among thirty hearing-impaired students with hearing loss of 70-90 dB and thirty normal hearing students. They were selected from 3[rd] grade primary school students in Hamadan, a large city in Western Iran. The language skills and non language information was assessed by questionnaire, Action Picture Test, and Sentence Perception Test. Results showed that there was a significant relation between writing sentences and perception of written sentences in hearing impaired students [p<0.001], [r=0.8]. this significant relation was seen in normal-hearing students as well [p<0.001], [r=0.7]. Disability of hearing-impaired students in verbal communication is not only related to articulation and voice disorders but also is related to their disability to explore and use of language rules. They suffer lack of perception of written sentences, and they are not skilled to convey their feeling and thoughts in order to presenting themselves by using language structures

Receptor activator of nuclear factor kappa B ligand [RANKL] levels in peri-implant crevicular fluid

Receptor activator of nuclear factor kappa B ligand [RANKL] is one of the key cytokines in the induction of osteoclastogenesis both in vitro and in vivo. Several reports indicated the presence of sRANKL in gingival crevicular fluid of patients with periodontal diseases. To determine the presence of RANKL in peri-implant crevicular fluid samples of implants with peri-implantitis, peri-implant mucositis and healthy controls. In this study, 40 implants were categorized as clinically healthy, peri-implant mucositis and peri-implantitis according to the clinical and radiographic findings. Filter paper strips were used to collect peri-implant crevicular fluid for 30 seconds in the base of the crevice/pocket. Peri-implant crevicular fluid [PICF] samples were obtained from buccal and lingual aspects of implants. Plaque index, probing depth, gingival index and bleeding on probing were recorded at six sites per implant. Enzyme-linked immunosorbent assay [ELISA] was performed to determine the PICF levels of sRANKL. There were no statistically significant differences in sRANKL concentration between healthy group, peri-implant mucositis and periimplantitis [p=0.12]. There were also no statistical correlation between the concentration of sRANKL and probing pocket depth [R=0.051, p=0.65], or any of the other clinical regarding [p>0.05]. No differences between the mean sRANKL concentration in the buccal and lingual sites were found [p=0.693]. Our results may suggest that peri-implant crevicular fluid analysis of sRANKL in conjunction with some other osteoclastogenic mediators could be further investigated in further well-designed prospective longitudinal studies on a larger-scale sample size in the evaluation of dental implants

Survival at 1, 3, and 5 years in diabetic and nondiabetic patients on hemodialysis

We analyzed survival of 185 adult patients on maintenance hemodialysis [9 h/wk to 12 h/wk] at Emam Khomini Hospital in Ahvaz, Iran. Patient survival at 1, 3, and 5 years was 89.2%, 69.2%, and 46.8%, respectively. There was no significant difference between diabetic and nondiabetic patients in 1-year survival [87.1% versus 89.7%, P = .66]. But, 3- and 5-year survival rates of diabetic patients were significantly lower than those of nondiabetic patients [52.2% versus 73.8%, P = .04; zero versus 56.9%, P < .001; respectively]. Based on our findings, the survival of diabetic patients undergoing hemodialysis was much worse than survival of nondiabetic patients. Thus, prevention of diabetic nephropathy should be more emphasized; and if end-stage renal disease is present, other renal replacement therapies such as kidney transplantation must be considered as soon as possible