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Introduction: Despite different methods implemented, surgical wound infection is still an important cause of mortality and morbidity of patients which impose a considerable cost on health care system. According to recent data, administration of supplemental oxygen during operation can reduce the risk of wound infection due to increased tissue oxygenation and therefore better elimination of bacteria by oxidative killing. This study is done to investigate the effect of administered oxygen ratio on the incidence of wound infection in clean-contaminated surgery. Materials and Methods: This is a double blind clinical trial. 584 patients from both sexes between 18 to 60 years old, who were condidated for clean-contaminated surgery were divided into two equal groups randomly. One recived 80% and the other 40% FIO2 during anesthesia. The frequency of wound infection between the two groups was assessed during a two weeks period. Results: Of patients receiving 80% FIO2, 11 (3.9%) patients, and the group recieving 40% FIO2, 25(8.1%) patients had wound infection (p<0.05). Conclusion: This study similar to previous studies showed the positive effect of supplemental oxygen in decreasing risk of surgical wound infection. Therefore according to the low risk and low cost and effectivness of this method in patients undergone surgery, it is recommended in clean-contaminated surgery.

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Background: Hydatid disease is a common infection caused by Echinococcus granulosus. Cerebral involvement is very rare and only occurs in 2% of all hydatidosis in endemic areas. We report a case of primary multiple cerebral hydatid cysts in a 23 years old patient. Case: A 23 years old female was admitted in our emergency ward with primary generalized tonic colonic seizure, left body and face hemiparesis and history of headache in last two months. Contrast enhanced CT and MRI showed a big well-defined, rounded, cystic lesion in the motor strip of right temporo-parietal region with mass effect causing midline shift which was diagnostic for brain hydatid cyst and several smaller cysts. There was no evidence of other organs involvement. The patient underwent the brain surgery. A big hydatid cyst (10cm in diameter) and some others adhering to brain parenchyma in different sizes were evacuated completely and without rupture using Dowling method. Patient received albendazole 400mg/two times a day for 2 months too. There was no cyst in patient’s MRI study in two years follow up.

Conclusion: Though low incidence, primary multiple cerebral hydatid cysts should be considered in endemic area using brain CT and MRI. Surgery is standard treatment of the disease.

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Background: Fungal spores are present in large amounts in the nature which may cause diseases in the susceptible individuals. Fungal rhinosinusitis has been increased during recent decades. This study aims to investigate fungal rhinosinusitis in the patients with chronic needing endoscopic sinus surgery aims and to determine the sensitivity of the isolates to rhin sinusitis antifungal agents.

Materials and Methods: In cross sectional study, specimens were obtained in sterile plates containing normal saline. from the suspected cases of chronic rhinosinusitis who had undergone endoscopic sinus surgery. Microscopic experiments and Cultures were done in Sabouraud Dextrose Agar medium. Minimum inhibitory concentration (MIC) of the growth of fungi for seven antifungal agents against the isolates was determined using E-Test.

Results: In total, specimens from 102 immunocompetent patients were examined. Nine positive specimens were presented, consisting of 3 for Aspergillus fumigatus, 3 for Penicillium, 2 for Aspergillus flavus and 1 for Alternaria. The mean age of the patients was 38 years, with 59 males and 43 females. The isolates were most sensitive to the voriconazole and amphotericin B.

Conclusion: Since the prevalence of fungal rhinosinusitis is low, unfortunately, the clinicians are not attentive enough to the condition, and they initiate antifungal therapy if the patients are not responsive to antibiotics. Early diagnosis and suitable treatment can help more efficient management of patients.

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Abstract

Background: Bariatric surgery is the most effective intervention for treating severe obesity and patient's adherence to self-management behaviors is essential to reduce complications after surgery. The purpose of this study was to investigate the psychometric properties of BSSQ in Iranian population.

Materials and Methods: The statistical society was all of the obese patients that underwent laparoscopic obesity surgery in Shiraz Ghadir Mother & Child Hospital from December 2016 till June 2016, and 201 of them (149 females and 52 males) were selected by using available sampling method. They responded to demographic characteristics, post bariatric surgery self-management behaviors questionnaire and general and specific adherence scales. For validity, methods such as content validity, structural validity (factor analysis and correlation analysis), simultaneous validity were used. The reliability of the questionnaire was determined by using bisection and internal stability methods by Cronbach s alpha.

Results: According to the results of explatory factor analysis, sisx factors including eating behaviors, physical activity, fruits, vegitables, grain and protein intake, fluid intake and dumping syndrome management were elicited, that these 6 factors explained 61.54% of variance of self-management behaviors. Total score of correlation matrix BSSQ with GAS & SAS were 0.363 and 0.702. For reliability, the Cronbach's alpha coefficient of this instrument was found 0.90 and guttman split-half coefficient was 0.78.

Conclusion: Results show that BSSQ has an acceptable validity and reliability and it can be used for assessing the post bariatric surgery self-management behaviors in Iranian population.

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Introduction: The present study was conducted to investigate the effectiveness of schema therapy on marital satisfaction and mental health of women undergoing hysterectomy surgery.
Methods: This research was applied in terms of objective and quantitative research, and in terms of data collection method, it was semi-experimental research with two experimental and control groups with pre-test and post-test. The statistical population consisted of all women aged 30 to 50 who underwent hysterectomy surgery in 2023 in Yazd city. In this study,
30 eligible subjects were selected by the available method, and the participants were randomly divided into two experimental and control groups (15 people in each group). For the experimental group, the treatment plan was implemented in 10 sessions of 50 minutes. Goldberg's mental health questionnaire and Inrich's marital satisfaction questionnaire were used to measure the research variables.
Results: The findings from the analysis of the covariance test showed the use of the schema therapy approach increased the marital satisfaction and mental health of women undergoing hysterectomy surgery (p ≤ 0.001).
Conclusions: Therefore, the use of schema therapy sessions in medical centers for people who underwent hysterectomy surgery is suggested to reduce marital problems.

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Introduction: Some intracranial surgeries must be performed while the patient is awake. Awake craniotomy is an intracranial surgical procedure in which the patient remains in a state of controlled consciousness while the surgery is performed. The aim of this study was to present a case of intracranial surgery to remove a tumor in the right frontal cortex using awake craniotomy.
Case Report: This report describes the anesthetic management of a 22-year-old male undergoing craniotomy with a fully awake technique. This was the first case of craniotomy performed entirely awake (from the beginning to the end of the operation) at Arak University of Medical Sciences and Valiasr Hospital in Arak, After preoperative preparation and evaluation, scalp nerve blocks targeting the cranial nerves innervating the scalp and head muscles were administered at specific sites. Mild sedation was provided using oxygen supplementation, followed by surgical incision. The lesion was examined intraoperatively while the patient remained awake, and the tumor was safely excised under full wakefulness. A combination of local and regional anesthesia and light intravenous sedation was utilized. Two types of local anesthetics, lidocaine 1.5% and bupivacaine 2.5%, were used for anesthesia, as well as intravenous sedatives and anesthetics such as propofol, remifentanil, and dexmedetomidine were administered for sedation. Throughout the operation, the patient was awake and breathing spontaneously, and the function of the brain nerves during the operation could be evaluated. Finally, the patient's surgery was performed without any complications and in stable condition, and the patient was transferred to the intensive care unit in good general condition, awake and fully alert.
Conclusions: Although maintaining analgesia and hemodynamic and adequate ventilation during fully awake craniotomy poses challenges, this technique is critical for intraoperative monitoring of cranial nerve function and preventing neurological deficits. By precisely administering scalp nerve blocks and carefully titrating sedatives (propofol, remifentanil, dexmedetomidine), we successfully performed the procedure under full wakefulness. With this method, potential surgical complications are prevented, and the patient also experiences satisfactory painlessness. Applying this technique was satisfactory for our patient.