Background: Surgical intervention has been recently advocated in the treatment of morbid obesity. The objective of this study was to review surgery as an alternative in the treatment of morbidly obese adolescents.Materials and Methods: This research was conducted by searching English websites such as PubMed, Up to Date, and Google Scholar, as well as some Persian websites including SID, Iranmedex, and Magiran. Articles published from 2000 to 2010 on interventional and clinical trials were reviewed for treatment of morbid obesity in adolescents. Keywords used in internet searches include obesity; adolescence; and surgery.Results: The results obtained from the studies indicated that 4% of American adolescents suffer from morbid obesity. So far, pharmacological treatment and other approaches toward this type of obesity have been inefficient. Hence, surgery was employed as one of the new approaches to the treatment of this disorder. According to the National Health Institute criteria, in the treatment of adolescent candidates for surgery, anthropometric measurements are performed together with the measurement of other co-morbidities of obesity. Adolescents whose percentiles are³99 are considered as morbidly obese patients.Conclusion: The results of the studies suggested that for the extremely obese adolescents, who do not respond to other types of medical interventions within 6 months, surgery can be performed. Adolescents with BMI of³40 kg/m2 and skeletal maturity, or those with co morbidities of obesity, or 13-year-old girls and boys³15 years of age can be candidates for surgery. However, the side effects of obesity should not be neglected. Therefore, before the adolescent obesity become morbid obesity, preventive measures should be taken through changes in lifestyle.

When thinking about medical team responsibilities in surgical procedures, one question comes to mind: «In the event that during a surgical procedure a patient is harmed or looses his/her life. Who will be held responsible?» Would it be the head surgeon who is in charge of the medical team? Or is one or more member of the team responsible? Is the medical team not responsible because they were just following orders from the head surgeon? Or they are responsible?There are many theories regarding this issue. Some of these theories are such as: charitable responsibility, employer responsibility, co-operative responsibility, ship caption responsibility, Legal responsibility and … The view point of this article with respect to the mention of theories is to pay attention to medical team responsibilities in surgical procedures and fair legal procedures regarding doctors and patients.

Background: The purpose of the present study is to report the incidence of operating room fires during hand surgical procedures. Methods: The clinic and OR electronic medical records of seven fellowship-trained orthopedic hand surgeons at a single, large practice were retrospectively reviewed. All upper extremity procedures performed between June 2014 to June 2019 in both hospital and surgery center settings were included in the review. Demographic data was collected. The incidence of operating room fires was determined. Results: A total of 18, 819 hand and upper extremity surgical procedures were included. There were 16, 767 (89. 1%) cases performed in a surgery center, while 2, 052 (10. 9%) of cases were performed in a hospital. There were 12, 691 (67. 4%) soft tissue procedures and 6, 127 (32. 6%) bony procedures performed. Chlorhexidine gluconate preparation solution was used in 9607 cases (51%). Chloraprep solution was used in 6280 cases (33. 4%). Betadine was used in 2, 932 cases (15. 6%). One surgeon has monopolar electrocautery only available during cases. Five surgeons have bipolar available, and one has both mono and bipolar electrocautery available. There were no fires (0%) identified during the study period. Conclusion: The incidence of operating room fires during hand surgical procedures is extremely low. While hand surgeons can be reassured that the likelihood of an operating room fire is minimal, surgeons should not become complacent and should maintain a high level of vigilance to prevent these potentially devastating occurences.

Background: Adverse Events (AEs) due to failure in healthcare procedures are common. These procedures are often evaluated independently. The objectives of this study are to investigate the nature of the failures in healthcare procedures of the surgical patients, assessing the frequency of these failures and preventability, and exploring their consequences, underlying causes, and prevention strategies in a referral hospital in the center of Iran.Materials and Methods: This study is a prospective quantitative and qualitative research. Focus Group Discussion (FGD) meetings have been conducted to understand potential failures, their consequences, causes, and prevention strategies. Afterwards, the frequencies of these concepts have been determined separately in predefined subcategories in each step of the process.Results: The first phase of the patient care process was the most risk-prone phase. Temporary or permanent disability at the time of discharge (final impacts), inflammation/infection (injuries), the rule-based behavior associated with coordination (causes), information and communication, preventability more than 50 were the most frequent failures and had achieved the highest score.Conclusion: Failures of healthcare processes are preventable to a high degree, although patients injure frequently. Interventions to mitigate these failures will enhance the reliability of surgical procedures.

Purpose: To compare the long term results of three different procedures for correction of involutional entropion (tarsal strip, three fornix sutures, tarsal strip + three fornix sutures) among patients referred to Labbafinejad Medical Center during 1991-2001.Method: Study was performed on the hospital records of all patients with lower lid entropion who underwent surgery. Patients with less than three months of follow-up and previous operation on the same eyelid were excluded from the study. Age, gender, visual acuity, method of operation, results of operation, improvement of symptoms, and post surgical complications were reviewed.Results: During this period, 67 lids in 51 patients underwent surgery including lateral tarsal strip (LTS) in 26 lids (38.8%), three fornix sutures in 11 lids (16.4%), and the combined procedure in 30 lids (44.8%). Patients were followed for a minimum of three months and average of 6.5 months. Symptoms were epiphora, foreign body sensation, abnormal lid position, decreased vision, and burning sensation. Lid position correction rate was 88.5% for LTS, 90.9% for three sutures, and 96.7% for the combined method. Total cure (lid position and symptoms) was achieved in 76.9% of LTS cases, 72.7% of three sutures cases, and 86.6% of the combined procedures. Two cases of complications were seen, including granulation tissue formation in the lateral canthus and stitch abscess.Conclusion: The combined procedure seems to have better results in terms of symptomatic improvement and lid position than the two other procedures.