Introduction of a handmade vacuum-assisted sponge drain for the treatment of anastomotic leakage after low anterior rectal resection

Purpose@#Anastomotic leakage, a known major postoperative complication, potentially leads to readmission, reoperation, and increased mortality rates in patients, such as rectal cancer patients following a low anterior resection (LAR). Currently, vacuum-assisted closure, as featured by B-Braun (B-Braun Medical B.V.), is already being used for the treatment of gastrointestinal leakages and fistulas. The main aim of this study was to introduce a novel method for creating a vacuum-assisted drain for the treatment of anastomotic leakage after LAR. @*Methods@#All 10 patients, who underwent LAR surgery from 2018 to 2019, were diagnosed with anastomotic leakage and had received neoadjuvant chemotherapy prior to surgery. Therefore, patients were treated with a handmade vacuum-assisted drain and were revisited every 5 to 7 days for further evaluations and drain replacement until leakage resolution. Physical features of cavity, time of diagnose, and duration of treatment were analyzed correspondingly. The handmade vacuum-assisted sponge drain was prepared for each patient in each session of follow-up. @*Results@#Eight out of 10 patients experienced complete closure of the defect. The mean delay time from the day of operation to the diagnosis of anastomotic leakage was 61.0±80.4 days while the mean time for leakage closure was 117.6±68.3 days. Eventually, 7 cases underwent ileostomy reversal with no complications during a 3-month follow-up. @*Conclusion@#In this study, we evaluated the healing process of anastomotic leakage after the usage of a handmade vacuum-assisted sponge drain in a case series method. In our trial, we provided an innovative cost-benefit method easily applicable in the operating room.

Acceleration of skin wound healing with tragacanth [Astragalus] preparation: an experimental pilot study in rats

Gum tragacanth is a natural complex mixture of polysaccharides and alkaline minerals extracted from species of Astragalus plant, which is found widely in arid regions of the Middle East. In a pilot experimental study we examined the effects of its topical application on wound healing in ten albino adult male rats. Two similar parasagittal elliptical full-thickness wounds [control vs. test samples] were created on the dorsum of each animal. Test group samples were fully covered by a thin layer of gum tragacanth daily. The extent of wound healing was evaluated by planimetric analysis on multiple occasions during the 10-day study period. On the 7[th] day of the study, the percent of wound closure was significantly higher in gum tragacanth-treated specimens compared to the control samples [87% +/- 2% vs. 70% +/- 4%, P<0.001]. The majority of wounds in the test group were completely closed by the 10[th] day of the study. The difference in wound healing index measured by histological examination on day 10 of the study was also statistically meaningful between the two groups [0.624 +/- 0.097 vs. 0.255 +/- 0.063, P<0.05]. The results of this study clearly showed the useful effects of topical application of gum tragacanth in acceleration of skin wound contraction and healing. More studies are encouraged to identify the implicating agents and precisely understand the mechanism by which they exert their wound healing effects

Prediction of elders' general health based on positive and negative perfectionism and type-D personality

Multiple factors such as retirement, work disability, social rejection, physical illness and etc., have an impact on general health of the elders. One factor among others is the role of psychological variables. The study is intended to assess the effect of positive and negative perfectionism and Type-D personality [distressed] on general health of the elders. In this descriptive-correlation study, 80 people [47 male and 33 female] were selected from residents of Nursing Home in Hamadan and Malayer using non-probability [accessible] sampling method. They responded to the questionnaires of Type-D Personality, Goldberg and Hillier's General Health and Positive and Negative Perfectionism of Terry-Short et al. Positive perfectionism [r = 0.30] and type-D personality [r = 0.32] had significant correlation with general health. Multiple regression analysis revealed that positive perfectionism and type-D personality could explain at least 49% of the variance in general health. Concerning the variables of negative affectivity, social inhibition and social function, the females' mean was higher than that of males and considering the variables of positive perfectionism, and social functioning, the males' mean was higher than that of females. Positive perfectionism decreases mental disorder of the elders by creating optimistic attitudes and enhancing social functions. On the other hand, type-D personality, unlike positive perfectionism, makes elders susceptible to physical illness and mental disorder

effectiveness of lifestyle training in relapse prevention and resiliency enhancement for people with substance dependency

Drug addiction is a complex disorder that incorporates multiple factors including those related to genetics, beliefs, unconscious processes, gender, and temperament as well as developmental, social, economic, and political factors. The present study investigates these factors. The aim of this study is to determine the effectiveness of lifestyle training in relapse prevention and resiliency enhancement in people with substance dependency. In a semi-experimental study, 26 subjects with a diagnosis of opiate use disorders in the Jameiate Aftab Center of Tehran who had successfully detoxified, were divided into two groups, an experimental group [12 subjects] and a control group [14 subjects]. The participants were selected according to available sampling methods. The experimental group underwent 12 sessions of coping skills training while the control group did not receive any treatment. All subjects in the study were assessed by the Conner-Davidson Resiliency Scale [CD-RIS] and a test for morphine before treatment, after treatment, and at a 4-month follow-up stage. Data were analyzed using descriptive methods as well as t-test and ANCOVA analyses. The x[2] test showed that the experimental and control groups significantly differed in relapse rates chi [2] = 6.30, df = 1, P < 0.001]. In addition, the covariance analysis showed a significant difference between the two groups in resiliency enhancement at post-test [F = 33.76, P < 0.001] and follow-up [F = 37.67, P < 0.001]. The results indicate that lifestyle training is effective in resiliency enhancement and relapse prevention for people with substance dependency

Validation of the adult domain-specific hope scale in Iranian postgraduate students

The aim of the present study was to investigate psychometric properties and the Standardization of Simpson's Hope Scale [1999] in Iranian university students. In this descriptive-survey research, 1000 students with age range of 18 to 34 and with the mean age of 23.9 +/- 5.13 were selected via the categorical cluster sampling method from different universities. Then they answered the Snyder's Hope Scale, Oxford Happiness Scale, the Ahwaz Hardiness Scale, the Beck Hopelessness Inventory, Riff's Psychological Well-being Scale, as well as Sympson's [1999] Hope Scale [with little change]. Coefficients of Cronbach's alpha [0.94], split-half [0.85], convergent validity with Hardiness [0.40], Happiness [0.64], Psychological Well-being scales [0.47], divergent validity [Beck Hopelessness, -0.25] criterion validity [Snyder's Hope 0.55] were calculated, which were significant at p<0.01 level. The exploratory factor analysis showed that the 40-item Hope Scale for adults is saturated with five factors [social, academic, family, occupational, and leisure hope] that explain 56% of the scale's variance. Second-order confirmatory factor analysis indicated that the five mentioned factors are well loaded on a principal factor, and therefore, the six-factor model was well fitted with the data [AGFI=0.93, RMSEA= 0.037, NFI=0.98]. The results showed that this test has high reliability and validity and can be used in other studies.