bibliometric study of epidural anesthesia: a 24-year review

After introduction of epidural anesthesia [EA] in the early 20[th] century, it has become an essential technique in anesthesiology and many physicians consider it the gold standard analgesic technique for major surgeries. As EA has improved anesthesia methods dramatically and aimed to perform a scientometric analysis on this topic. Cross-sectional study Mashad University of Medical Sciences, Iran Articles were retrieved from the Web of Science [ISI] from 1990 to 2013. Intervention[s]: The total number of published items was 4612; subsequent analysis was performed on results considering published items per year, country, funding agency, institution, journal, publication language, and author and subject area. The results were analyzed considering published items per year, country, funding agency and institution, journal, publication language and author. Additionally, subject areas under which the articles were published were evaluated. The primary search yielded 4612 publications; out of these 3200 [69.38%] were original articles. More than half of articles [2466] were published under "anesthesiology" subject. The USA was the leading country in producing articles under this topic and engaged highest collaboration rate with 64 collaborations. It seems that there is an overall increase in total number of articles, citations and highly cited articles about EA during these two decades

Different types of anastomotic methods: a review of literature

Constructing successful anastomosis is an important concept in gastrointestinal tract surgeries, which can be affected by various factors such as preoperative bowel condition, intra- and postoperative complications, bleeding and the device characteristics. Suturing, stapling and compression anastomosis are different techniques. Despite the invention of compression anastomosis, which goes back almost two centuries, this method has not obtained the popularity of the suturing and stapling anastomosis and further studies are required. Designing methods and devices with no drawbacks might reduce the complications associated with anastomosis as the alternative to suturing and stapling anastomoses. Several materials can be used as reinforcement materials, which can improve the consequences of the stapled anastomosis. In addition to reinforcement materials, other forms of supports have been proposed, which might be capable of reducing the postoperative complications of anastomosis. In this study, we briefly review various types of anastomotic techniques and associated complications in different types of gastrointestinal surgeries

Successful treatment of congenital chyloperitoneum with platelet-rich fibrin glue

Congenital chyloperitoneum is an uncommon clinical condition. A few cases of congenital chyloperitoneum in children have been described who were treated in a variety of methods. Congenital chyloperito was diagnosed in a 5-day-old baby boy with a significant abdominal distension. Due to the failed conservative managements by medium-chain triglycerides [MCT] enriched milk and partial parenteral nutrition [PPN], the authors tried platelet rich fibrin glue [PRFG] as an alternative choice which was applied through an already inserted intra-abdominal catheter. PRFG successfully stopped the lymph leakage from all over the small intestinal mesentery; thereby PRFG may be considered as an effective alternative treatment before surgical intervention. Applying PRFG is an easy, safe, and effective alternative option that may be used to close the chylous ascites lymph leakage in children if conservative management with PPN fails

[Comparison of blood loss in femoral shaft surgeries between tranexamic acid and controlled hypotension]

Blood loss reducing approaches improve surgery outcomes through producing an appropriate operation field and reducing transfusion need. In this study two blood loss reducing techniques were compared. In a randomized clinical trial study 60 patients candidate for elective femoral shaft operation were devided in two groups. The first group went under induced hypotensionand the second group received tranexamic acid. Anesthesia technique and surgeon were the same in both groups. Bleeding amountwas measured based on site operation site and reservoir observing, pads counting. Traputic interventions such as crystalloids or colloids and blood transfusion were done as needed. Results were evaluated by Mann-witney U test. Dry field and surgeons satisfaction was good in 23 patinets of the hypotention group [76%] and was moderate in the rest of the group. In the tranexamic group the results were good in 21 patients [70%]. There was no significant difference in reducing blood loss between the groups. Both of the studied techniques can reduce bleeding and improve operation field and surgeon satisfaction, meanwhile there was no significant difference in two approaches

[ outcome of transanal anorectal myectomy in the patients with ultrashort_segment hirschsprung's disease]

Anorectal myectomy and anal dilation under anesthesia could be an effective way in the treatment of patients with ultrashort_segment Hirschprung.In this article we studied the outcomes of anorectal myectomy. Our study group was 61 patients with the disease who had reffered to SHEIKH hospital from the second half of 1386 to the first half of 1388. Barium enema and anorectal myectomy was performed in all patient. Follow up after myectomy was in the second week after surgery and then monthly. For the complications and results, patients were also divided in to 3 groups based on the presence or absence of ganglion cell in the muscular resectal region,and the results were compared in each group. Bleeding, infection of the operation zone, sepsis, entrocolitis, and anal stenosis was not observed in any patient after surgery. 4 patients had gas incontinence and 3 had fecal incontinence after surgery which was cured in 3-6 months with bio-feedback orders. 40 patients [87.5%] had complete remission after surgery and 2[4.17%] had partial remission and 4[8.33%] had no remission at all. Based on these results, there is no relation between gender, complications of surgery and the results of surgery. Anorectal myectomy could be an effective treatment strategy for patients with following situations: absence of anatomical abnormalities-chronic constipation in spite of medical treatment-absence of transitional zone in barium enema-failure of anorectal reflex relaxation with rectal distention in anorectal manometry

[Outcomes of rectopexy of rectal prolapse through anus by sub mucosal injection of 5% dextrose]

Considering the vast methods of rectal prolapsed, a very common condition in children, either surgical [by abdominal or perineal approach] or non-surgical [sclerozing agents' injection], the authors evaluated the therapeutic effects of injecting dextrose 50% through perineal rectopexy. All those referred patients with rectal prolaps to Dr. sheikh children hospital were included in this study. All were sub-mucusally injected 5 cc of dextrose 50% solution and the therapeutic results [recurrence and complications] were evaluated. During this study 46 patients were injected about 5 cc of dextrose 50% solution. All went through the operation without any complications and during a 6 month following up none of the complications such as fistulae, abscess formation, urinary retention, and mucosal necrosis were detected. Nine patients were re-injected due to the prolapsed recurrence however no complications occurred in the second operation. The described procedure is a simple, inexpensive, and repeatable one. Deflux has been suggested as the best sclorizing agent in articles but it is expensive. Sub-mucusally injection of dextrose 50% is a simple, inexpensive, and repeatable procedure with a 100% positive therapeutic results, therefore could be, suggested as a substitution procedure in treating children's rectal prolapsed