Introduction: The right use of BLOOD is necessary because of the high cost of correct BLOOD screening, BLOOD grouping, and cross match. The purpose of this study is to evaluate the rate of the reserved and cross matched BLOOD before elective surgeries which were done in Bahman 22nd Hospital. It also aims at evaluating the standard guideline for ordering BLOOD.Materials and Methods: This is a retrospective study from 1380 to 1388 that evaluates evaluating 6145 files of the patients hospitalized in 22 Bahman 22nd Hospital for surgery during the years of 1380 to 1388. The elective operations include General surgery, Gynecology, orthopedic, ENT, Urology and Neurosurgery. The number of patients, the number of reserved and cross matched units and the number of transfused units was recorded for each group of patients collected in each groups. Finally, the number of reserved BLOOD units in that period of time and in each group was compared with the standard guideline. Also the number of transfused BLOOD units was evaluated. The ratio of cross matched to transfused BLOOD units lower than 2.5 was considered as standard. And The obtained data were analyzed, using with SPSS.Results: A total of 1557 BLOOD units of BLOOD were reserved for 772 patients.1305 units (66.47%) were cross matched, but just 126 units (8.1%) were transfused. The effective factors in increasing the possibility of transfusion were the ages<20 & >80 years old, Hb £ 12, the type of surgery and the surgeon. Although after the application of the guidelines in1385, there was 64.44% decrease in the rate of cross matching rate due to the decrease in the number of patients who were cross matched, but the average of cross matched units for each patient did not change. The total of C/T index of the hospital decreased from 14.1 to 3.7.Conclusion: The appropriate correct BLOOD reserving can decrease the unnecessary BLOOD reserves, lower the pressure on BLOOD banking centers and prevent BLOOD wastage.

Purpose: To report visual and anatomical outcome of flap LOSS after LASIK surgery for correction of high myopia. Materials & Methods: Retrospective evaluation of flap LOSS in two eyes of two patients, a rare complication of LASIK Surgery. Case No. 1: 27 y/o woman with Ref. OD -9.75; 2.75*177 VA. CC: 20/60 KR OD: 41.86*77 39.86 * 168 & partial amblyopia due to anisometropia. Case No. 2: 38 y/o woman with Ref OD. -9.50 1.0*177 VA CC: 20/30 KR OD: 42.06*77 40.99 * 167. Results: In both patients during LASIK surgery free cap complication occurred and after Laser therapy free cap positioned over the stromal bed, but the next day after operation flaps were lost. For case NO.1only medical management performed and after 4.5 years F/U cornea has 2° central haziness. For case NO.2 another corneal flap from donor globe cut and sutured with Nylon 10/0 and after 18 months F/U cornea is clear. Conclusion: In patients with flat keratometry less than 41.0 Diopter rate of free cap are high and after laser therapy for high myopia the keratometry became more flat. If surgeon doesn't suture flap the rate of flap LOSS increase so for prevent of corneal haziness and corneal ectazia this evaluation suppose to perform donor corneal flap graft.      

Background: Estimating intraoperative BLOOD LOSS can be a difficult task, especially when BLOOD is mostly absorbed by gauze. In this study, we have provided an improved method for estimating BLOOD absorbed by gauze.Objectives: To develop a guide to estimate BLOOD absorbed by surgical gauze.Materials and Methods: A clinical experiment was conducted using aspirated BLOOD and common surgical gauze to create a realistic amount of absorbed BLOOD in the gauze. Different percentages of staining were photographed to create an analogue for the amount of BLOOD absorbed by the gauze.Results: A visual analogue scale was created to aid the estimation of BLOOD absorbed by the gauze. The absorptive capacity of different gauze sizes was determined when the gauze was dripping with BLOOD. The amount of reduction in absorption was also determined when the gauze was wetted with normal saline before use.Conclusions: The use of a visual analoguemayincrease the accuracy of BLOOD LOSS estimationanddecrease the consequences related to over or underestimation of BLOOD LOSS.

Background: One of the typical problems of cell savers is the retransfusion of the heparin added to the system. The aim of this study was to determine whether or not heparin, remaining in the prepared sample of retransfusion BLOOD, might be responsible for disturbance in coagulation and increase in BLOOD LOSS.Methods: Fifty patients undergoing coronary artery bypass grafting surgery (CABG) were randomly divided into two groups: group C (n=25) received cell-saver BLOOD and group H (n=25) received homologous BLOOD. Volumes of the intraoperative autologous and homologous transfusion, activated clotting time (ACT) of the transfused BLOODs, and ACT and amount of BLOOD LOSS in the patients were measured intra and postoperatively.Results: There was no statistical difference between the groups in terms of demographics, preoperative characteristics, or operative details. Cell saver was used in 25 cases, and the average volume of BLOOD autotransfused was 504±158 mL. A significant statistical difference was observed in the mean volumes (460±200 vs.80±160 mL; P=0.0001) of perioperative allogeneic BLOOD transfusions between groups H and C. Despite significant further cell-saver BLOOD transfusion (504±158 cc vs.338±123 cc; P=0.001) and a significantly longer ACT of cell-saver BLOOD than homologous BLOOD (959±85 sec vs.478±58 sec; P=0.0001) intraoperatively, there was no significant difference between the two groups in terms of postoperative BLOOD LOSS (510±270 cc in group H vs.454±150 cc in group C; P=0.362).Conclusion: Utilization of a cell saver was safe, with no increased risk of bleeding despite heparin added to the system.

Introduction: Hemorrhage in trauma is important and replacement of the BLOOD LOSS is one of the ways which may reduce the number of mortalities. We decided to study the use of hypersaline serum in comparison with normal saline serum and not prescribing blowing serum in caring animal simulation model of uncontrolled hemorrhagic shock following trauma.Objectives: The assessment of 3% hyper saline serum application compared with saline normal serum and not prescribing blowing serum in caring animal simulation model of hemorrhagic shock in trauma.Materials and method: The animal lab investigation and the grant of this animal trial was provided by AJA University of medical science. The goats were sedated with Ketamine and Diazepam. The tracheostomy was done on the goat and was ventilated with portable ventilator. Continuous BLOOD pressure and electrocardiogram monitoring was positioned. Animals were cut and BLOOD volume was measured. The bleeding was not being controlled and after 300-350 ml of bleeding, the goats were randomized into 3 groups; those treated with normal saline 20 ml/kg (n=10), hypersaline 3% 6 ml/kg (n=10) and no fluid resuscitation (n=10). Data related to the duration of survival, volume of lost BLOOD, BLOOD pressure and metabolic acidosis were gathered and analyzed.Results: BLOOD volume LOSS in normal saline group, hypersaline group and no volume resuscitation group was 1139 ml, 1551 ml, 600 ml respectively. The mortality rate significantly increased using hypersaline. Also, BLOOD acidosis increased and hemoglobin decreased significantly while using normal and hypersaline serum vs. no fluid resuscitation.Discussion and conclusion: Resuscitation with normal saline or hypersaline can increase BLOOD LOSS during a hemorrhagic shock and do not improve survival.