Background: POSTOPERATIVE pulmonary COMPLICATIONs (PPC) are important problems that prolong hospital stays by increasing morbidity and mortality of patients. Early identification of risky cases through preoperative evaluation is important for reducing the COMPLICATIONs that may be seen in patients POSTOPERATIVEly. The aim of this study is to calculate, evaluate and compare the risk indices for PPC in patients who will undergo elective abdominal surgery. Materials and Methods: One hundred twenty-four patients who were hospitalized for elective abdominal surgery were included in this prospective observational study. American Society of Anesthesiologists (ASA), Epstein and Shapiro scores, respiratory failure index (RFI), pneumonia risk indexes (PI) and scores were calculated preoperatively. Patients were re-evaluated at the 48th POSTOPERATIVE hour, and one-week follow-up was performed. The patients with PPCs are recorded. Results: The mean PPC rate was 36. 8%. Based on this, pleural effusion was observed in 18. 5%, prolonged mechanical ventilation in 8. 9%, atelectasis in 9. 7%, and respiratory failure in 5. 7%, bronchospasm in 4. 0%, and pneumonia in 3. 2% of patients. An increased risk in PPC was determined if ASA were above 3 (odds ratio, [OR], 7. 06,<0. 001), PI scores were above 3 (OR, 6. 67,<0. 001), RFI score were above 4 (OR, 6. 30, p: 0. 001) and Shapiro score above 2 (OR, 20. 01,<0. 001), respectively. Conclusion: The Shapiro index is the strongest predictor of pulmonary COMPLICATIONs, whereas the PI is the strongest predictor of morbidity risk. However, RFI and the PI are equally valuable for predicting respiratory COMPLICATIONs and may prove to be useful in abdominal surgeries for preoperative assessment.

Introduction: Esophageal cancer is among the most common malignancies. Hospital mortality in the past decade reduced; but its morbidity is still high. Pulmonary COMPLICATIONs are the most common COMPLICATIONs after esophageal resection. In this study we examined the effect of steroids administration during surgery to reduce POSTOPERATIVE morbidity with a focus on respiratory COMPLICATIONs. Material and Methods: Patients with esophageal cancer who underwent transhiatal esophagectomy, randomly divided into two groups to thirty patients: The intervention group (received 125mg methylprednisolone sodium succinate). After surgery, patients admitted in the ICU for a day. Oral feeding initiated on day 7th and patients discharged home on the day 8th or 9th. POSTOPERATIVE COMPLICATIONs included anastomotic fistula, wound infection in the neck and abdomen and pulmonary COMPLICATIONs. We analyzed pulmonary COMPLICATIONs included pneumonia, Acute lung injury (ALI) or acute respiratory distress syndrome (ARDS) occurred before the seventh day. The leukocyte counts and CRP levels measured on the 2nd and 7th days after surgery. Results: 60 patients enrolled in the study. Incidence of ARDS, ALI and pneumonia in the control group was 3, 5 and 2 and in steroid group 1, 1 and 1 respectively. CRP levels and blood leukocyte count was similar in two groups on the second day but seventh day values and difference between the two levels between the second and seventh days were significantly different between the two groups (p<0. 001). Conclusion: Intraoperative single dose corticosteroids are effective in preventing pulmonary COMPLICATIONs after transhiatal esophagectomy. Methylprednisolone reduced the increase in CRP levels after surgery and decreased blood leukocyte count more in POSTOPERATIVE period.

The internal mammary artery (IMA) has become important graft material in coronary artery bypass grafting (CABG). It has proved to be the most long-lasting of the available graft material and is now used routinely in many centers. This study was done to evaluate effects of pleurotomy during CABG on POSTOPERATIVE COMPLICATIONs. In this prospective study, 200 patients undergo CABG electively in Shaheed Rajaii Hospital, were divided in two groups: group A (with pleurotomy) and Group B (without pleurotomy). The following variables were evaluated for each patient: duration of mechanical ventilation, ABG, POSTOPERATIVE pulmonary COMPLICATION and parameters, and the length of ICU stay. Data was analyzed by the Hest, chi-square test, and nonparametric tests. P Value <0.05 considered significant. In our study pulmonary COMPLICATIONs, and ICU stay have shown no significant difference in two groups (p>0.05). Only incidence of pleural effusion was higher in group A (p<0.05). Therefore we concluded that opening the pleura during CABG does not increase post operative morbidity.

Introduction: Awareness during anesthesia is a side effect associated with general anesthesia and refers to a condition in which brain awakens by a stimulus during a period of general anesthesia. The experiences are stored in explicit memory and patient might recall a few things after recovering from anesthesia. The experiences are sometimes in the form of pain perception, but the patient is not able to show a reaction due to the administration of muscle relaxants, the feeling of weakness and helplessness caused by intraoperative awareness might cause some patients to develop lasting and significant psychological issues. Given the importance of monitoring and maintaining the depth of anesthesia, this study aimed to determine the incidence of awareness and recall during general anesthesia. Materials and methods: A total of 400 patients who were referred to Besat Hospital and underwent various surgical procedures in 2016 were involved in this study. Data collection was performed using a questionnaire previously utilized by other researchers to study the same topic. Patients were visited 24 to 36 hours after recovery and interviewed about their experiences before, after and during operation. The data collected from each patient were then recorded in the patients questionnaire form. Results: data were obtained from patients indicates that out of 400 patients, 249 patients were men (62. 3%) and 151 patients were women (37. 7%). In order to induce, propofol was used in 71. 8%, thiopental sodium in 27. 3% and ketamine in 0. 9% of patients. Benzodiazepines were used as preanesthetic agents in 87. 8% of cases. Ten patients (2. 5%) had pointed to issues that suggested consciousness during anesthesia. The only significant connection in this study was found to be the lack of use of benzodiazepines and awakening during anesthesia. Conclusion: Given the increased risk of awakening during anesthesia without use of benzodiazepines as preanesthetic drugs, we suggest administration of these agents as far as possible in general anesthetics. Also, our findings indicate that the prevalence of consciousness during anesthesia is higher in our country compared to other countries.

Todays due to immunological and surgical techniques and increasing COMPLICATION related to hemodialysis, increasing number of patients scheduled for renal transplant and secondarily ocular COMPLICATION of immunosuppressive agents increased. Therefore early diagnosis & management of these COMPLICATIONs can prevent devastating problems. Our aim was to determine the incidence and type of ocular COMPLICATION of renal transplant and its correlation with other variables such as, age sex, donor type and duration of renal failure and dialysis.We selected 42 patients without history of any ocular disease and surgery. In each visit, complete eye examination was done. Patients received 500 mg Methyleprednisolone intravenously that started one day before operation and continued 2 days POSTOPERATIVEly, then changed to Prednisolone 20mg/daily. Also POSTOPERATIVEly, Cyclosporine A and Azathioprine started with 5 and 1 mg/kg respectively and continued with tapering doses. The results compared pre and POSTOPERATIVEly with Chi- square and Mann Whitney tests.Total number of patients was 42 cases and donor was three groups: cadaver, relative and non- relative. Of all patients, male & female were 76% and 24% respectively with average age 34.4 year (14-54) with mean 12.6 months follow up (6-24). The most common COMPLICATION was cataract (45%) but no significant correlation was found between cataract and total dose of steroid, age, sex, duration of dialysis and renal failure. In 7% of patients open angle glaucoma and in 5% bilateral peripheral dendritic herpetic keratitis without inflammation developed.Regarding the ocular COMPLICATION of renal transplant drugs, it is better that these patients followed regularly to prevent of COMPLICATION and early treatment.

Gallstones are among common complaints of human societies. Its prevalence has been estimated about 10%in western societies. As operational manipulation is still the method of choice in symptomatic gallstones, post-operative side effects and complaints, like remained gallstone in common bile duct, are studied.In a retrospective study we have reviewed the files of the patients hospitalized in Shariati Hospital due to post-operative side-effects of cholecystectomy, 1997.We have studied 34 patients with post-cholecystectomy syndrome. The mean age was 61. RUQ pain was the most common complaint of the patients, and high level of alkaline phosphatase was the most common laboratory finding. Remained gallstones were diagnosed much more than bile duct stenosis and stump syndrome. Among 26 patients with remianed gallstones, sonography has successfully diagnosed 21 cases, whereas ERCP has determined definite diagnosis. Endoscopic sphincterotomy was successfully performed in 18 patinets, but the remaniers (l6 patients) required surgical intervention. Remaining gallstone is the most common complaint of post-cholecystectomy syndrome that demands careful attention during gall bladder surgery, especially in old patients. In case of encountering this problem, endoscopic sphincterotomy should be the first choice, fortunately it succeeds in more than half of the patients, then in case of unsuccess, reoperation is recommended.