[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

Long term effects of kidney donation on blood pressure and kidney function of donors

Kidney transplantation from a live donor has many advantages, but the donor should undergo a major surgery and accept potential morbidity and mortality. In this study, we evaluated the long term effects of nephrecetomy on renal function and blood pressure of kidney donors. In this cross-sectinal study, we assessed 195 kidney donors. The controls were 100 healthy individuals with two kidneys. The variables were age, sex, systolic blood pressure [SBP], diastolic blood pressure [DBP], serum creatinine, creatinine clearance and proteinuria [all before and after kidney donation] and time interval between donation and study. Data analysis was accomplished using SPSS software, and paired t-test and Pearson correlation coefficient were used for data analysis. Although serum creatinine was elevated at the time of study, but this rise was not significant. SBP at the time of study was significantly greater than the time of donation [P<0.001]. Creatinine clearance at the time of study was significantly lower than the time of donation [P<0.001]. There was no correlation between serum creatinine, creatinine clearance, SBP, DBP and age at the time of kidney donation in men. Age at the time of kidney donation was correlated with SBP and DBP and creatinine changes in women [P=0.001 and P=0.002, respectively]. This study showed that nephrectomy does not impair renal function in donor and does not lead to a progressive rise in blood pressure or urine protein excretion up to 6.5 years after nephrectomy. Nevertheless, we suggest that kidney donors should be selected after exact screening for potential risk factors of renal disease

Hydatidosis of tibia

A 71 year old female from a village was admitted to Ahwaz Imam Khomeini hospital in southwestern part 7 years ago with pain and swelling at the upper and middle third of right tibia. Operation was performed and permanent sinus secretion of the midportion occurred. After 7 years the patient returned to hospital recently with warmness, swelling and edema and sinus secretion in middle and upper of right leg. Radiological examination revealed osteolytic metaphyseal and diaplyseal lesion with honey combs appearance transitional zone was narrow without reactive bone and incomplete fractures were also noted. Abdominal sonography was normal. Wound discharge culture indicated Klebsiella, Proteus and E. coli. After antibiotic therapy the patient was put under general anesthesia and complete excision of middle part of tibia from proximal metaphysic to distal metaphysis was performed. During the operation laminated layers and daughter cysts of hydatid cysts were seen. The lesion was washed with 0.5% of NO3Ag and 3cm under the tibia plateau to 7cm of tibia planoid was debrided and cement spacer was used for filling the spaces. Histopathologic examination of the resected specimen confirmed the hydatid cyst. The patient was prescribed albendazole and discharged from the hospital. She is being followed up now