Comparison of surgical site infections between laparoscopic and open cholecystectomy

Background: This study assessed the causes of infection in cholecystectomy and compared the infection rates between the open and laparoscopic cholecystectomy

Materials and Methods: This was a retrospective cohort study, performed on all patients admitted to Shariati Hospital since February 2017 for cholecystectomy. Initially, the patients were evaluated for infection risk factors, and then surgical site infection rates in these individuals were measured. Infection was assessed at the time of patients discharge [in the first few days after surgery] and again a month later, either in clinic or by phone. Information from 81 patients was collected, and SPSS software version 24 was used to analyse the data using appropriate statistical tests. Statistical significance was defined as p value < 0.05

Results: The mean age of the participants was 45.89 +/- 13.38. The relationship between surgical site infections [SSI] and age, sex, comorbidities [diabetes, hypertension, ischemic heart disease, malignancy, chronic lung disease, and chronic kidney disease], taking corticosteroids, smoking, and the emergency or elective nature of the surgery was not significant. The mean age of the patients who underwent open cholecystectomy was higher than the laparoscopic group [p = 0.005]. Similarly, the average hospitalization period for those underwent open cholecystectomy was higher [p = 0.03]. Finally, the infection rates for open cholecystectomy were 6 times higher than laparoscopic surgeries [RR: 6.11]

Conclusion: There was no significant relationship between SSIs and the risk factors assessed in this study. However, infection rates were higher in the open cholecystectomy group. More studies on the various risk factors of infection and the differences between the laparoscopic and open surgical methods are required

Endovascular repair of supra-celiac and abdominal aortic pseudo aneurysms concomitant with a right atrial mass in a patient with behcet's disease: a case report

Behcet's disease is a rare immune mediated systemic vasculitis which besides it's more frequent involvement of eyes and skin, sometimes present with aortic pseudo aneurysm and more rarely cardiac inflammatory masses. A 51-year-old patient with Behcet's Disease presented with two symptomatic aortic pseudoaneurysms concomitant with a right atrial mass. Computed tomography [CT] revealed one supra-celiac and another infrarenal aortic pseudoaneurysms. Echocardiography showed a large mobile mass in the right atrium. Both pseudoaneurysms were successfully excluded simultaneously via endovascular approach with Zenith stent-grafts, and the atrial mass was surgically removed 10 days later. Post-implant CT showed successful exclusion of both pseudo-aneurysms, patency of all relevant arteries, and patient is now asymptomatic and has returned to normal lifestyle. Multiple pseudoaneurysms concomitant with a right atrial mass can be an initial manifestation of Behcet's disease. Endovascular repair can be a good treatment option for the pseudoaneurysms

Pattern of animal-related injuries in Iran

Animal related injuries as most common causes of human morbidity have different pattern by geographical zones. We aimed to explore the main descriptive epidemiology of animal-related injuries in both rural and urban areas in Iran. Between 2000 and 2004, we collected the data of all the cases of animal related trauma hospitalized for more than 24 hours in eight cities [Tehran, Mashhad, Ahwaz, Shiraz, Tabriz, Qom, Kermanshah, and Babol]. Further evaluations were conducted on 17753 eligible subjects. Of 17753 traumatic patients, 40 subjects [0.2%], had animal-related injuries. The highest rate was seen in Tabriz with 11 cases. Upper and lower extremities were the most frequent sites of trauma and they were injured in 13 and 11 cases respectively. Dog bite and cow-related injuries were responsible for 40% and 32.5% of injuries respectively. Amputation of the phalanx was done in 2 cases due to dog bite and bull gore occurred. One thoracotomy, one laparatomy and one craniotomy were done. One patient needed fasciatomy due to snake bite. Educating the patients could decrease the incidence of morbidity of these injuries