[Evaluation of gastric surgery complications and their management in patients hospitalized at Ayatollah Taleghani hospital]

Gastric surgeries are still among the major causes of surgery complications. Study on prevalence of these complications and recognition of their risk factors are strongly needed. To study Gastric surgery complications and strategies for their management in patients hospitalized at Ayatollah Taleghani hospital. In this Cross-sectional study all gastric surgeries at Ayatollah Taleghani hospital between 1994 and 2002 were assessed. Variables were age, sex, type of surgery, indication of surgery, type of complication and management strategy [medical or surgical]. Data were collected from patients' medical records. Indications for surgery were gastric malignancy and neoplasia in 277 patients [59.8%], peptic ulcer in 151 [32.6%], and other causes in 7.6%. The most prevalent surgeries were Billroth II [23%] and total gastrectomy [15%]. The highest level of complications was observed in Billroth II [24%]. Complications of surgery occurred in 42 cases [9%] among those 33 males and 9 females. Except for vagotomy and pyloroplasty, less than 50% of complications needed surgical management. This study showed that the prevalence of gastric surgeries complications is 9%, comparable to those found in other studies. The most prevalent surgeries were Billroth II and total gastrectomy, believed to be associated with relatively higher level of complications

Pituitary dependent Cushing's syndrome in Iran

During a 5-year experience with 32 adrenal tumors with different basic problems in the Department of Endocrinology, Taleghani Hospital, 25 were found pituitary dependent Cushing's syndrome, "Cushing's disease." The treatment of patients with Cushing's disease depends on the presence or absence of pituitary tumor. If no pituitary tumor is demonstrated, irradiation can be given to the pituitary gland and if a pituitary tumor is present, hypophysectomy is the treatment of choice. If pituitary ablation fails to relieve the symptoms of Cushing's syndrome, bilateral adrenalectomy is usually performed through the posterior approach. With regard to the poor results of radiation and hypophysectomy in Iran, these patients were referred directly for bilateral adrenalectomy to the Department of Surgery, Taleghani Hospital. The disease was predominatly seen in the young age group, females were more frequently affected than males and the common manifestation of hyperadrenocorticism were obesity, plethora, amenorrhea, and hirsutism. The diagnosis was made by a series of laboratory, roentgenographic, and C.T. scan studies. The surgical ablation of the target organs was usually performed by the posterior approach, and the pathologic results of operated patients were nodular hyperplasia and diffuse hyperplasia