effect of local tramadol injection in post appendectomy pain

Tramadol is a weak synthetic opioid with an effective analgesic result. This medicine has both systemic and local anesthetic effects on peripheral nerve system. The purpose of this study is to compare post-appendectomy analgesic effect of subcutaneous injection of tramadol with normal saline. This double blind study was conducted on 60 patients over 15 years old, who were randomly divided in two equal groups, i.e. tramadol and normal saline. After repairing fascia in appendectomy, 100 mg of tramadol that was diluted up to 10 mL and 10 mL normal saline were used for subcutaneously injection around the surgical wound in experimental and control groups, respectively. Then, the intensity of pain was recorded in the recovery room, and 6 and 24 hours after operation, based on NRS. In addition, number of petidine [with a dosage of 25 milligram] administered in the same period, in case of severe and moderate pain, was recorded. At the end, the intensity of pain during the mentioned time and the average use of petidine in two groups were compared. The average of severe pain in recovery time [3.08 +/- 1.44 versus 5.36 +/- 2.02], 6 [3.36 +/- 1.22 versus 5.36 +/- 1.38] and 12 [2.08 +/- 0.76 versus 3.08 +/- 1.15] hours after operation was lower in tramadol group [P = 0.0001]. Moreover, the amount of consumed petidine in the same period of time showed a clear reduction [P < 0.05]. Subcutaneous injection of tramadol is an appropriate choice for reduction of post-appendectomy pain and decreasing need for potent narcotic painkillers. This treatment method can decrease side effects of using potent narcotics after appendectomy

Comparison of hemorrhoid sclerotherapy using glucose 50% vs. phenol in olive oil

Sclerotherapy is a safe mode of hemorrhoid treatment with minimum costs and side effects. The expensive present sclerosants reduce our tendency to use this technique, so we conducted this study in a try to replace them. This is a prospective study on 170 hemorrhoid cases visited at Imam Ali and Khatam clinics during a year. Patients were randomly divided into case and control groups. After sedation and proctoscopy 3 ml of "50% glucose" and "phenol in olive oil" solutions were injected in each hemorrhoid pile of case and control groups respectively. Patients were assessed 1 week and 3 months thereafter. Data was analyzed via SPSS-17 software, using chi[2] and t-student tests. Out of 71 cases and 73 controls, 55.6% were female. The most common chief complaint was bleeding [51.4%]. Two groups were even regarding gender, age and chief complaint. [p-value respectively 0.412, 0.876, 0.146]. Bleeding after one week and 3 months and response rate didn't show a significant statistical difference between 2 groups. [p-value respectively 0.914, 0.731, 0.422]. Finally 19 patients didn't respond to any treatment [13.2%]. In an even sample sclerotherapy with 50% glucose can be as efficient as phenol in olive oil solution. Regarding cultural characteristics, we hope that evolving non surgical techniques may encourage patients to seek early treatments

Diagnostic value of leukocytosis, ESR and CRP in patients with suspected acute appendicitis

This study aimed to determine the value of the ESR, CRP and Leukocyte count in the diagnosis of acute appendicitis. This is a retrospective [descriptive-analytic] study which was conducted from August 2007 until October 2008 in Zahedan. A sample of 426 available patients with suspected acute appendicitis -who had been admitted to Ali-ebne- Abitalib and Khatam-al-Anbia hospitals- were recruited to participate in this study. Patients' demographic data, their blood samples for ESR, CPR and Leukocyte count were collected and sent to the laboratory for analysis. SPSS-16 was used to analyze data. A number of 426 patients were investigated. Nearly 59.9% were male and 81% of the patients had leukocytosis. 214 cases of inflamed papillae [50.4%], 102 cases of exudation [23.9%], 36 cases of gangrene [8.5%] and 25 cases of perforated appendicitis were observed during the operations. Seven cases had abscess or flegmon. Pathological reports of 84 patients [19.7] showed normal appendices. Sensitivity and specificity value of ESR and CRP tests were [71.9 and 39.0%] and [85.0% and 57.0%] respectively. Positive and negative predictive value [PPV and NPV] of both tests were 83, 25, 89, and 48% respectively. ESR and CRP and leukocytosis had significant statistical correlation with phonological results. The results of this study showed that in addition to physical examination, some basic laboratory findings such as ESR, CPR and leukocytosis can be helpful. Among these, the value of CPR in the diagnosis of acute appendicitis is higher