Safety of latex urinary catheters for the short time drainage

In this study, we attempt to identify the most appropriate catheter [silicone vs. latex] for short-term urinary catheterization. We compared the post-operative clinico-pathological complications between latex and silicone for short term catheterization in rabbits with hypospadias. Forty rabbits were used in our study to compare complications of catheterization. They were divided in two groups. Hypospadias like defect was created by a 1 cm long excision of the ventral urethra. For urethroplasty, we used tubularized incised plate technique. Latex and silicon catheters were used in groups 1 and 2, respectively. Post-operatively, routine laboratory urine test and complications [allergy, infection, bleeding] were compared in groups. A total of 40 rabbits underwent hypospadias repair. Findings showed that there were no significant differences between groups based on urine test indices [P = NS]. Urinary tract infection rate was 10% [2 rabbits] in latex and 0% in silicone groups [P = NS]. There were no significant differences between groups regarding of cystitis grades between study groups [P = NS]. It seems that urinary tract catheterization with latex catheters is a safe, feasible, and in-expensive procedure for short-term post-operative course in hypospadias surgery in patients without latex hypersensitivity

Epidemiology of livestock-related injuries in a major trauma center in Kashan, Iran / 中华创伤杂志(英文版)

<p><b>OBJECTIVE</b>Livestock-related injuries are one of the important factors causing morbidity and mortality in patients admitted to hospital. Treatment of these patients is still a major problem in health care system. The aim of current study was to assess the epidemiology of livestock-related injuries in a major trauma center in Iran from 2006 to 2011.</p><p><b>METHODS</b>In a prospective study, patients with livestock-related injuries who were consecutively admitted to the trauma center in Kashan, Iran between 2006 and 2011 were evaluated. The data collected included patient's demographics, place and nature of accident, damaged organ, educational level, transport and outcome. Data were expressed as mean +/- standard deviation.</p><p><b>RESULTS</b>A total of 129 patients were included in this study, accounting for 0.3% of all trauma admission (40 273 cases). The mean age was (55.27 +/- 14.45) years. Men were affected four times more than women. Falling down from livestock is the main mechanism of trauma in all groups. Upper and lower extremities were most frequently injured (n equal to 72), followed by the head, neck and spine (n equal to 33 for each). There was one death resulting from livestock-related injury in this study.</p><p><b>CONCLUSION</b>Despite the low incidence, livestock-related injuries can damage major organs of human body and therefore appropriate training program to increase the safety awareness in home and outdoor is very important.</p>

Ischiorectal Block with Bupivacaine for Post Hemorrhoidectomy Pain

BACKGROUND: Hemorrhoid is one of the most common surgical diseases occurring in the anorectal region. In this study, we evaluated the effect of ischiorectal fossa block on alleviating post hemorrhoidectomy pain. METHODS: In this study, 90 patients suffering from hemorrhoids were evaluated. They were randomly divided into 3 groups. The first group had no block, the second group an ischiorectal block with placebo (normal saline), and the third group a preemptive ischiorectal block with bupivacaine. Postoperative variables such as pain intensity, pethidine consumption, nausea, and vomiting were compared between the groups. RESULTS: The postoperative pain score in group 1 was 8.5 +/- 1.3 and 8.1 +/- 0.9 (P = NS) in group 2. The post operative analgesic demand was 3.1 +/- 1.5 and 3.3 +/- 1.8 hours in groups 1 and 2, respectively (P = NS). The post operative pain score and analgesic demand were 4.2 +/- 2.1 and 9.3 +/- 2.7 hours, respectively, in group 3 (P < 0.0001). CONCLUSIONS: Preemptive ischiorectal block reduces the posthemorrhoidectomy pain and opioid demand.

Epidemiology of pediatric burn injuries in Isfahan, Iran

Burns are major cause of death and disability worldwide, particularly in the developing countries. The aim of this study was to determine the incidence and causes of burns in children under the age of 15 years in Isfahan province, Iran. All children admitted to the burn center of Isfahan, the largest city in central Iran, between 2007 and 2009 were enrolled in this study. We analyzed the data on age, sex, location, cause and spread of the burn, duration of admission, and cause of mortality. Out of 2229 burn patients, 1014 [45.5%] were under the age of 15, indicating an annual incidence of 50 in 100,000 children. Of the 1014 patients, 610 [60%] were boys and 404 [40%] were girls; the male-to-female ratio was 1.5:1. Most of the patients were in the age range of 3 to 6 years. Scald was the most common type of burn injury [51.8%]. Six-hundred and sixty-eight cases [65.7%] were from urban areas, while 346 [34.3%] were from rural areas. Fifty-six patients [5.5%] died. Burn injury is a major health concern in the pediatric age group, and specific consideration and planning are required for its management

Simple and safe packing method for high-grade liver injuries

Injury to the liver is a commonly encountered problem in trauma cases and is a frequent cause of morbidity and mortality. Because gauze packing is easy to use and has the potential for rapid hemorrhage control, it is the most commonly used method for patients with severe liver injuries, particularly those with coagulopathy. In this study, OpSite sheets were used to make three-layer packs for decreasing the complication associated with removing gauze packing. Twenty male patients with grade IV or V liver injuries that required laparotomy were enrolled in the study. Ten patients were treated using conventional packing, while the other 10 were treated using the three-layer pack. In the case group, the liver was mobilized as much as possible. The three-layer pack was then placed at the site of liver damage and extended onto the liver surface, and the other pads were placed on top of this pad. After 72 h, reoperation was performed, the packs were removed, and the packs causing injury were recorded. Additionally, if rebleeding due to the adhesive bands of the pack was observed, the blood was suctioned and bleeding volume was measured. Data were analyzed using the Mann-Whitney test. Patients in the case and control groups were similar in age and admission vital signs. During the second operation, the bleeding volumes measured in the case and control groups were 66 +/- 27.01 mL and 152 +/- 85.4 mL, respectively. There was some padinduced damage after the removal of the pad in the control group. Our study has provided a simple and safe packing method for high-grade liver injuries

Appearance time of methylene blue in the aorta: intra-osseous vs peripheral intravenous route

The intra-osseous [IO] route serves as an appropriate venous access site if access is needed in an emergency. In this study, we compared the appearance time of methylene blue [MB] in the aorta following IO and peripheral intravenous [IV] routes in a rabbit model to assess a novel idea and compare the speed of IV and IO route of serum delivery into the main circulation. Twenty rabbits were used in our study. They were divided into two groups [odds as Gl, n=10, evens as G2, n=10]. After laparotomy, the aorta was located and can-nulated by a 16 gauge angiocatheter. For IV injection in Gil, the marginal vein of either ear was accessed. For IO injection in Gl, the medial surface of the proximal extremity of left tibia was used. Once satisfied with positioning, 10 ml of methylene blue solution at a concentra-i tion of 10 mg /ml was injected and the time was recorded. The time taken from injection to appearance of MB in the aorta was measured. All rabbits survived until the end of the experiment. There was no significant difference between the groups regarding the body weight. There was no significant difference between mean time of dye entry into the aorta in either group. It was 9.66 +/- 2.51 seconds in Gl and 10.24 +/- 1.95 seconds in G2 [P = 0.56]. Our study demonstrated that there was no significant difference between the time taken for MB to reach the central circulation via IO or IV routes

Preemptive Use of Ketamine on Post Operative Pain of Appendectomy

BACKGROUND: Although early reviews of clinical findings were mostly negative, there is still a widespread belief for the efficacy of preemptive analgesia among clinicians. In this study, we evaluated whether the preemptive use of ketamine decreases post operative pain in patients undergoing appendectomy. METHODS: In double-blind, randomized clinical trials, 80 adult male patients undergoing an operation for acute appendicitis were studied. Patients were randomly assigned to two groups. In the operating room, patients in the ketamine group received 0.5 mg/kg of ketamine IV 10 minutes before the surgical incision. In the control group, 0.5 mg/kg of normal saline was injected. The pain intensity was assessed at time 0 (immediately after arousal) and 4, 12, and 24 hours postoperatively using the 10 points visual analogue scale (VAS). RESULTS: Eighty patients (40 for both groups) were enrolled in this study. For all of the evaluated times, the VAS score was significantly lower in the ketamine group compared to the control. The interval time for the first analgesic request was 23.1 +/- 6.7 minutes for the case group and 18.1 +/- 7.3 minutes for the control (P = 0.02). The total number of pethidine injections in the first 24 hours postoperatively was 0.6 +/- 0.6 for the case group and 2.0 +/- 0.8 for the controls (P = 0.032). There were no drug side effects for the case group. CONCLUSIONS: A low dose of intravenously administered ketamine had a preemptive effect in reducing pain after appendectomy.

Evalution of validity of Alvarado scoring system for diagnosis of acute appendicitis

Hemorrhagic shock and resuscitation is welt known to result in myocardiat dysfunction and injury. Stimulation of the Na[+]-H[+] exchanger plays an important role in the pathway of myocardial injury. The purpose of the present study was to examine the protective effects of blocking the cardiac Na[+]-H[+] exchange, using 100mM ethyl-isopropyl amiloride [EIPA], a specific Na[+]- ft exchanger blocker, on myocardial contractile function on ex vivo resuscitation of isolated rat heart following one hour of hemorrhagic shock. Sprague- Dawley rats-were assigned to-hemorrhage, hemorrhage + EIPA, sham hemorrhage and sham hemorrhage + EIPA groups. Rats were hemorrhaged for one hour. Hearts were harvested and ex vivo treated and resuscitated by perfused in the Langendorff System. Myocardial function was determined. The results showed that inhibition of the Na[+]-H[+] exchanger using EIPA improved the post-resuscitation myocardial contractile function. Blocking the Na[+]-H[+] exchanger using 100mM EIPA following 60 minutes of hemorrhagic shock improved myocardial function