A review of the application of cellulose hemostatic agent on trauma injuries.

INTRODUCTION: Planning for management of bleeding in trauma injuries is very important. The initial purpose in emergency situations should be immediate establishment of an efficient hemostasis, principally in its topical application. In this study, we aimed to review the major relevant articles in the case of application of cellulose hemostatic agent on trauma injuries. METHODS: We searched the online databases such as PubMed, MEDLINE, Wiley, EMBASE, ISI Web of Knowledge, and Scopus. Two reviewers independently searched and assessed the titles and abstracts of all articles. RESULTS: Upon screening the titles and abstracts, 24 studies were identified for full-text review. The oxidized cellulose had the best clotting times, while it demonstrated low absorption ability. Surgical and thermosensitive chitosan hemostatic could be valuable for managing hemorrhage from liver injuries in trauma patients. CONCLUSION: Recently, the application of cellulose hemostatic agents has been one of the main improvements obtained for controlling bleeding in trauma injuries. However, generally according to the literature review, the decision about using each agent should be made on a case-by-case basis. However, it can be mentioned that the perfect hemostatic agent has not been still identified.

Stereological Comparison of Imbibed Fibrinogen Gauze versus Simple Gauze in External Packing of Grade IV Liver Injury in Rats.

OBJECTIVE: To evaluate the effect of imbibed fibrinogen gauze on survival, bleeding and healing in liver trauma. METHODS: This animal experimental study was conducted on 20 adult male Sprague-Dawley rats; with a mean weight of 300±50 gram; divided into two groups. Grade IV injury was induced to the subjects' liver. Then, the bleeding site was packed with simple gauze in the control group, and imbibed fibrinogen gauze in the experimental group. All animals were re-evaluated for liver hemostasis 48 hours after the initial injury. Bleeding in the intra peritoneal cavity was measured using Tuberculosis Syringe in the first and second operations. Subjects were followed-up for 14 days. Eventually, the rats were sacrificed and their livers were sent to a lab for stereological assessment. Statistical comparisons were performed via Mann-Whitney U-test using SPSS. P-Values less than 0.05 were considered to be statistically significant. RESULTS: Half of the rats in the control group died, while all the rats in the imbibed fibrinogen gauze group survived after two weeks (p= 0.032). Bleeding in the imbibed fibrinogen gauze was significantly less than control group, 48 hours' post-surgery (p<0.001). According to the stereological results, granulation tissue in the imbibed fibrinogen gauze group were more than the control group (P= 0.032). Also, fibrosis in the imbibed fibrinogen gauze group were more than the control group (P= 0.014). CONCLUSION: Our study indicated that imbibed fibrinogen gauze can potentially control liver bleeding and improve survival through increasing granulation tissue and fibrosis in injured liver.

Conjunctivitis as a manifestation of Wegener's Granulomatosis.

PURPOSE: To report a case of prolonged conjunctivitis as the manifestation of Granulomatosis with polyangiitis (GPA). METHODS: A 37-year-old man presented with prolonged conjunctivitis which had persisted for one month. He was taking medication for his conjunctivitis without any response. A slit-lamp examination revealed conjunctivitis and scleritis in the right eye. Conjunctivitis, 360-degree peripheral corneal thinning, corneal perforation, and scleritis were seen in the left eye. RESULTS: Emergency penetrating keratoplasty was performed to treat the patient's corneal perforation. After a consultation with the Internal Medicine Department, the patient was suspected of having GPA with positive cytoplasmic anti-neutrophil cytoplasmic antibodies (C-ANCA). Functional endoscopic sinus surgery was performed to treat right maxillary sinusitis, and a biopsy of the maxillary sinus mucosa was obtained. The pathology report showed granuloma and vasculitis with severe acute and chronic inflammation and few eosinophils; thus, the diagnosis was confirmed. CONCLUSION: Because prolonged conjunctivitis occurs only rarely in association with systemic disease, ophthalmologists should be aware of this potential, particularly in patients with GPA.

Distribution and Rates of Visual Field Loss across Different Disease Stages in Primary Open-Angle Glaucoma.

PURPOSE: To identify patterns and rates of visual field (VF) loss in primary open-angle glaucoma (POAG) across different levels of severity. DESIGN: Retrospective, observational case series. PARTICIPANTS: Visual fields of 278 eyes of 139 patients with POAG (9 years of follow-up with ∼17 visits) from the Rotterdam Eye Hospital in The Netherlands were analyzed to identify patterns and rates of VF loss. MAIN OUTCOME MEASURES: Rate of VF decline for the entire VF, each region, and test point. Hemifield asymmetric rate if VF decline for each region and test point. METHODS: Total deviation (TD) values were extracted from the Humphrey VF Analyzer (Carl Zeiss Meditec, Dublin, CA). Eyes were stratified into 3 glaucoma stages by means of the mean deviation (MD): better than -6 decibels (dB), worse than -6 dB and better than -12 dB, and worse than -12 dB. Each hemifield was divided into 5 regions according to the Glaucoma Hemifield Test (GHT): central, paracentral, nasal, and peripheral arcuates 1 and 2. Point-wise and region-wise asymmetric patterns of VF loss and rate of VF loss were identified by comparing the values in the superior hemifield and the inferior hemifield at each severity level using a generalized estimating equation. RESULTS: The mean age of the patients was 60.2±10.3 years (mean ± standard deviation [SD]). The rate of MD loss, for all eyes taken together, was -0.11 dB/year. In the cross-sectional analysis, in eyes in the early and moderate stages, central and peripheral arcuate 2 regions in the superior hemifield were worse than their inferior counterpart, whereas in the advanced stage all GHT regions in the superior hemifield were significantly worse than the corresponding regions in the inferior hemifield (P ≤ 0.05). In the longitudinal analysis, there was no significant difference in the rate of VF loss between the GHT regions in the superior and inferior hemifields. CONCLUSIONS: Our findings suggest that in POAG, VF damage is worse in the superior hemifield than in the inferior hemifield.

HIGHLIGHTS IN THE DIAGNOSIS OF BREAST NEOPLASMS.

Breast malignancies are one of the most prevalent and major causes of morbidity and mortality among women worldwide. According to the available data, neoplastic lesions of the breast are one of the main causes leading to heavy costs for both the healthcare system and the society. Based on these realities and the fact that different aspects of these malignancies remain unknown to date, and are essential to be determined, these issues make a vast area of research in medicine. Just like the present time, breast neoplasms were under the focus of scientists lived in the past, from all over the world. Accordingly, these malignancies are a group of disease with a long-standing historical background. As a result, it can be claimed that modern-day knowledge of these matters has burgeoned on the extraordinary discoveries and the development of diagnostic and therapeutic methods made through the ages, especially those of the post-medieval era. Recognizing the previous efforts that have been made in this regard will show our future way for us. For this reason, in this paper, we will review the key milestones and vital discoveries in the field of breast neoplasms and some other diseases involving this body organ.

Insights into Avicenna's contributions to the science of surgery.

An influential Persian scholar of the Islamic Golden Age of Medicine (from the ninth to the twelfth centuries AD), Ibn-e Sina (AD 980-1037), also known by the Latinized name Avicenna, is best remembered for his contributions to various aspects of medicine, particularly surgery. In fact, the art of surgery was a major focus of his attention and practice, and one to which he devoted several chapters of his main medical encyclopedia, Al-Qanun fi al-Tibb (The Canon of Medicine). This article presents a brief review of Avicenna's life, introduce his textbook of medicine, and present his significant contributions to the science of surgery.

How did Haly Abbas look at the cardiovascular system?

Persian scholars, especially those who lived during the Golden Age of Islamic Medicine (9th-12th century AD), made significant contributions to the healing arts and secured a place of honor for themselves in the history of this science. Abu l-Hasan Ali ibn al-'Abbas al-Majusi Ahvazi (? 930-994AD), with the Latinized name of Haly Abbas, was a scientist from this part of the world who contributed to the advancement of medicine. He is the author of Kamil al-Sina'ah al-Tibbiyah (The Perfect Book of the Art of Medicine), also commonly known as al-Kitab al-Maliki (The Royal Book), a medical encyclopedia renowned for its systematic and precise content. This textbook covers a wide variety of medical issues, among them topics related to the science of cardiology. This paper reviews the main points of Haly Abbas' knowledge of the cardiovascular system, of which little has been written until now.