Combination of intracostal sutures with muscle flap to decrease post thoracotomy pain: a singleblinded randomized clinical trial

Objective: To assess the efficacy of intercostal nerve protection by intercostal muscle [ICM] flap in post-thoracotomy pain improvement compared to intracostal suturing

Methods: In a randomized controlled trial, ninety-four patients undergoing posterolateral thoracotomy surgery were divided into two subgroups. Intracostal sutures in isolation and in combination with ICM flap techniques were used for thoracotomy closure in both groups. Numeric Pain Scale and Visual Pain Scale as pain scores were assessed on the first, second, third, fourth, fifth, sixth and seventh postoperative days and follow-up visits during the 2[nd] week, 1[st], 2[nd], 4[th] and 6[th] months after thoracotomy

Results: Out of 94 patients, 58 were male and 36 were females. While the mean age of patients in intracostal group was 45.3 +/- 17.6 years, it was 47.4 +/- 16.1 years in intracostal plus ICM flap group. The mean operation time for the first group was 191.0 +/- 74.7 minutes, while it was 219.3 +/- 68.8 minutes in the second [p>0.05]. Numeric rating score and visual pain scale did not demonstrate any significant difference in pain severity on postoperative days and follow-up visits between both groups [p>0.05]. Although the trend of pain reduction was significant in each group [p<0.001], the difference was not statistically significant [p>0.001]

Conclusion: Intracostal sutures in combination with muscle flap did not reduce postoperative pain in thoracotomy compared with intracostal sutures alone in thoracotomy closure

Genotyping of clostridium perfringens isolated from healthy and diseased ostriches [struthio camelus]

Clostridium perfringens is more prevalent type of clostridia genus isolated from the intestinal tract of ostrich [Struthio camelus]. Necrotic enteritis [NE] is a potentially fatal gastrointestinal [GI] disease of poultry and other avian species, which produces marked destruction of intestinal lining in digestive tract caused by C. perfringens. Pathogenicity and lesions are correlated with the toxins produced, thus toxin typing of the bacterium has diagnostic and epidemiological significance. The aims of the present study were to determine the biotypes of C. perfringens among ostrich's farms either diseased and healthy ones and to screen the isolates for major toxin genes [cpa, cpb, etx, and iA, cpb2, andcpe]. Thirty isolates of C. perfringens were obtained from NE-positive and NE-negative ostrich flocks in Khorasan-e-Razavi porvince and analyzed by multiplex PCR assay. All isolates were positive for alpha toxin gene [cpa] and five of those were positive for beta toxin gene [cpb]. The presence of cpb2 gene was detected in a high percentage of isolates originating from both healthy [93.3%] and diseased flocks [80%]. None of the isolates carried enterotoxin gene [cpe]. The results suggest that types A and C of C. perfringens are the most prevalent types in ostrich in Iran. Due to detection of beta2 toxin gene in isolates from both healthy and diseased birds, it appears that the presence of cpb2 is not considered a risk by itself

Histopathological and molecular study of Neospora caninum infection in bovine aborted fetuses

Objective: To estimate the extent to which abortion in dairy cows was associated with of Neospora caninum (N. caninum) and to determine the risk factors of neosporosis in dairy farms from 9 provinces in Iran. Methods: Polymerase chain reaction (PCR) test was used to detect Neospora infection in the brain of 395 bovine aborted fetuses from 9 provinces of Iran. In addition, the brains of aborted fetuses were taken for histopathological examination. To identify the risk factors associated with neosporosis, data analysis was performed by SAS. Results: N. caninum was detected in 179 (45%) out of 395 fetal brain samples of bovine aborted fetuses using PCR. Among the PCR-positive brain samples, only 56 samples were suited for histopathological examination. The characteristic lesions of Neospora infection including non-suppurative encephalitis were found in 16 (28%) of PCR-positive samples. The risk factors including season, parity of dam, history of bovine virus diarrhea and infectious bovine rhinotracheitis infection in herd, cow's milk production, herd size and fetal appearance did not show association with the infection. This study showed that Neospora caused abortion was significantly more in the second trimester of pregnancy than other periods. In addition, a significant association was observed between Neospora infection and stillbirth. Conclusions: The results showed N. caninum infection was detected in high percentage of aborted fetuses. In addition, at least one fourth of abortions caused by Neospora infection. These results indicate increasing number of abortions associated with the protozoa more than reported before in Iran.

Pathological description and immunohistochemical demonstration of ovine abortion associated with Toxoplasma gondii in Iran / 대한수의학회지

The obligatory intracellular protozoan parasite Toxoplasma gondii is a major world wide cause of infectious ovine abortion. In some different diagnostic techniques that are being used to detect this pathogen in ovine fetuses, immunohistochemistry (IHC) is a very sensitive and expensive one. Histopathology is not truly a specific and sensitive test for Toxoplasma infection but it can be helpful to choose some suspected tissues for IHC. In this study 9.5% of 200 samples (aborted ovine fetuses internal organs such as brain, liver, heart, lung, kidney, spleen) (4.6~14.4% with 95% CI) were positive in IHC with a very good logical agreement among different diagnostic techniques (kappa = 0.73, 0.8) and with no significant difference among different fetal age groups (p > 0.05).

Multimodal preincisional premedication to prevent acute pain after cholecystectomy

Postoperative pain as an important medical concern is usually treated by opioids which also are of various inevitable side effects. The aim of this study was to assess the efficacy of multimodal preincisional premedication on preventing post-cholecystectomy acute pain. In a randomized clinical trial, sixty patients undergoing open cholecystectomy were randomized into two groups. Before anesthesia induction, Diclofenac suppository [100 mg] and oral Clonidine [0.2 mg] were administered in the first group. Immediately before operation, patients received Ketamine [1 mg/kg IV] while the control group received placebo. The site of incision was infiltrated by the surgeon with 20 mL Bupivacaine 0.25% in both groups. Anesthesia induction and maintenance were similar in both groups. The severity of pain was recorded 2, 4, 6, 12, 24 and 48 hours after operation according to Visual Analogue Scale. The severity of pain at two defined stages [6 and 12 hours later] was significantly less in the intervention group than the control group [P<0.005]. The average pain severity score was less than the control group [P<0.005]. In our study, the administration of Clonidine, Diclofenac and Ketamine and bupivacaine infiltration to the site of incision, altogether was associated with a significant decrease in pain score and opioid requirement after cholecystectomy in comparison to bupivacaine infiltration to the site of incision.