The accuracy of Breastlight in detection of breast lesions.

AIM: Breastlight is a new product to improve breast health awareness of women. However, its accuracy in detection of breast lesions (BLs) is unknown. The aim of this study was to determine the Breastlight accuracy in detection of BLs. MATERIALS AND METHODS: From July 2011 to September 2013, a total of 500 women referred to mammography unit in Yazd, Iran for screening were recruited to the study. The sensitivity and specificity of Breast light was measured with clinical breast examination (CBE), mammography and sonography. Sonographic and mammography examinations were performed according to breast density among women in two groups of younger (n = 105) and older (n = 395) than 30 years. RESULTS: The results have shown a statistically significant positive correlation between Breastlight, CBE, sonography, and mammography in detection of BLs. Breastlight significantly detected 60.3%, 35.8%, and 59% of lesions which were detected by mammography, CBE, and sonography, respectively. Its sensitivity varied significantly with breast density. Comparing the sensitivity of Breastlight among women younger and older than 30 years indicated that the Breastlight had a higher sensitivity for women older than 30 years. The greatest and lowest portion of positive predictive value occurred with CBE (94.7%) and mammography (91.1%). As well, its greatest and lowest portion of negative predictive value occurred with CBE (65.6%) and sonography (29.7%). CONCLUSION: The results of this study showed that the efficacy of Breastlight in detection of breast changes as domestic apparatus was appropriate. However, it is recommended further studies to evaluate the Breastlight efficacy and accuracy in detection of the BLs.

Fentanyl transdermal patch (Durogesic® D-TRANS) for post abdominal laparotomy analgesia: a double blind randomized study.

AIM: The fentanyl transdermal patch (Duro-gesic® D-TRANS) is a strong pain medication for moderate to severe chronic pain that can provide long-lasting relief for persistent pain. This study was conducted to determine the analgesia and adverse effects of the fentanyl transdermal patch (Durogesic® D-TRANS) postelective laparotomy. METHODS: One-hundred twenty patients undergoing elective laparotomy were randomized into two groups of fentanyl and placebo. In the first group, patients received two fentanyl patches with 25 and 50 µg in 10 hours preoperatively. Patient's postoperative assessments included pain score, adverse effects, mean amount and interval of supplementary morphine, respiratory rate and oxygen saturation, which were recorded during 36 hours. RESULTS: The mean pain intensity scores over 36 hours in fentanyl transdermal patch durogesic (FTD) group were significantly less than placebo group (FTD, 35.28; placebo, 46.61 and P=0.01). However, the pain score at the 3rd timepoint in the placebo group was slightly less than the FTD group (39.4±2.23 vs. 39.47±4.97, respectively). The mean interval and amount of supplementary morphine were significantly better in the FTD group than the placebo group (FTD 367.7±349.7 min vs. placebo 59±13.88 min; P=0.04 and FTD 2.10±3.46 mg vs. 29.15±3.71 mg; P<0.001, respectively). The incidence of adverse effects including vomiting (FTD 16 vs. placebo 9; P=0.45), nausea (FTD 22 vs. placebo 18; P=0.33), itching (FTD 16 vs. placebo 18; P=1.00) and respiratory depression (FTD 1 vs. placebo 0; P=1.00) were not significant between the groups, except the dizziness that had a higher incidence in the FTD group (FTD 23 vs. placebo 1; P=0.02). CONCLUSION: It seems that the fentanyl transdermal patch system is a safe and effective procedure to use in post laparotomy analgesia and its related adverse effects are not serious.

Comparison of postoperative short-term complications after laparoscopic transabdominal preperitoneal (TAPP) versus Lichtenstein tension free inguinal hernia repair: a randomized trial study.

AIM: The aim of this randomized trial was to compare short-term postoperative complications of laparoscopic transabdominal preperitoneal (TAPP) and Lichtenstein tension free hernia repair. METHODS: A total of 120 patients who went inguinal hernia repair at Shahid Sadoughi university training hospital from April 2011 to August 2013 were randomized into two TAPP (N.=60) and Lichtenstein (N.=60) repair group. Follow-up occurred within 6 weeks. The postoperative assessments included pain score (VAS), hematoma/seroma, urinary retention, wound infection incidence, and duration of hospital stay. RESULTS: Pain was the most common symptoms in both groups. The TAPP group patients significantly had experienced less postoperative pain than the Lichtenstein group in all moments (P<0.05). TAPP group had lower incidence of hematoma (TAPP, 6.6% vs. Lichtenstein 13.3%; P=0.67), seroma (TAPP 10% vs. Lichtenstein 13.3%; P=1.00), and infection (TAPP 0 vs. Lichtenstein 1.6%; P=0.67). However, no differences between the 2 groups were found in terms of postoperative complications. In TAPP group mean of hospital stay significantly was less than Lichtenstein group (TAPP, 8.13±2.19 vs. Lichtenstein, 13.15±1.5 days; P<0.001). CONCLUSION: The laparoscopic TAPP repair is safer and less complicated approach to inguinal hernia repair. The two main short-term advantages of the laparoscopic TAPP repair with the tension free Lichtenstein repair were less postoperative pain and earlier return to the normal life activities. No difference was seen in overall complications.

Rectorrhagia and vaginal discharge caused by a vaginal foreign body--a case report and review of literature.

An 8-year-old girl was taken to an outpatient clinic of surgery suffering from rectorrhagia and purulent, smelly vaginal discharge. Colonoscopy and biopsy were done before referring and sulfasalazine regime was administrated for probable colitis. The surgeon performed a rigid rectosigmoidoscopy under general anesthesia and no positive evidence was found. Having examined the hymen, it was found to be intact but a purulent discharge was observed. After drying the discharge, a black foreign body was seen in the bottom of the vagina and brought out by a fine forceps. It was a toy's wheel. The patient and her mother both denied foreign body abusing history. It was recommended she go for a psychological consultation. Generally speaking, all young patients suffering from vaginal or rectal bleeding with or without discharge should have their vagina checked for a foreign body. What is recommended in such cases is to undergo sonography or plain radiography before considering invasive or non-invasive procedures for evaluating anal and sigmoid abnormalities. Last but not least, a vaginal irrigation, precise examination of hymen, and posterior fossa can prove very useful for detecting simple vaginal bodies that can lead to various vaginal, rectal and abdominal complications.