Comparison of the sonographic findings in laparoscopic cholecystostomy with and without hemostatic agent on 45-day follow-up of patients attending hospital.

INTRODUCTION: Cholelithiasis is one of the most prevalent pathological conditions, and elective laparoscopic cholecystostomy with and without hemostatic agent (HA) is the therapeutic approach to its treatment. This research study aimed to compare the sonographic findings of patients who underwent cholecystostomy with and without HA use. MATERIALS AND METHODS: This cross-sectional, descriptive-analysis study was conducted by available nonprobability sampling technique, and according to Cochran Formula, 144 patients, who underwent laparoscopic cholecystostomy, were recruited and divided into two groups including a group of 85 patients with HA use and a group of 59 patients without HA use. Patients in each group had sonography on discharge date and 15, 30, and 45 days after the surgery. Data were collected and entered in SPSS-24 software; meanwhile, descriptive statistics was used to analyze Chi-square test, Fisher's exact test, and Friedman and Wilcoxon nonparametric test. FINDINGS: The results of the study showed that the presence of echogenic mass with reverberation artifact (abscess mucosa) on 15- and 30-day follow-up sonography of patients, who underwent laparoscopic cholecystostomy, were significantly higher in patients with HA than in the group without HA (P < 0.05), and on 45-day follow-up sonography, there was no significant correlation regarding the presence of echogenic mass with reverberation artifact (abscess mucosa) and fluid in the two groups (P > 0.05). Besides, HA density significantly decreases in individuals over time (P < 0.05); however, there was no significant differences between HA reduction rate and gender (P > 0.05). CONCLUSION: These findings might be the indication of HA agents' effect on surgical operations and their resemblance to abscess. Due to the possibility of temporary immune responses to HA, as an external object, it is necessary, in vital pathologies, to pay close attention to what differentiates the normal imaging appearance in follow-up sonography.

Comparison of mammography and ultrasonography findings with pathology results in patients with breast cancer in Birjand, Iran.

BACKGROUND: Early diagnosis of breast cancer, the incidence of which among Iranian women is about a decade earlier than in developed countries, is important. OBJECTIVE: To compare mammography and ultrasonography findings with those of pathology in patients with breast cancer. METHODS: This descriptive cross-sectional study was performed using medical records of 79 patients with breast malignancies, who were referred to Imam Reza Hospital and private laboratories of Birjand, Iran, from December 2012 to December 2014. The patients' information was recorded using a checklist, which included name, code, age, ultrasonography, and mammography results and pathology reports. The results of ultrasonography and mammography were compared with pathology findings as the gold standard. SPSS Version 21 was used for data analysis. RESULTS: The mean age of the patients was 46.94 ± 11.76 years. The results showed that 74.7%, 16.5%, and 7.6% of the patients had ductal carcinoma, lobular carcinoma, and mixed carcinoma, respectively. About 72.5%, 24.6%, and 2.9% of the patients had stage 2, 3, and 1 breast cancer, respectively. In addition, both breasts were involved in 1.3% of the patients. The ultrasound findings were positive and false negative in 97.5% and 2.5% of the cases. Moreover, the mammography results were positive and false negative in 98.7% and 1.3% of the patients. CONCLUSION: This study showed that mammography is the preferred modality in screening breast cancer patients; the use of complementary tests such as ultrasonography is recommended, especially in high-risk women.

The comparison of saline enema and bisacodyl in rectal preparation before anorectal surgery.

BACKGROUND: Given the limited data on the need of mechanical bowel preparation application before anorectal surgeries and the preferred method for bowel preparation, we aimed to compare saline enema and bisacodyl in rectal preparation before anorectal surgery. MATERIALS AND METHODS: This is a randomized clinical trial study. Seventy-nine hospitalized patients for anorectal surgery (hemorrhoid, fissure, and fistula) were recruited by convenient sampling and then randomly allocated to receive 500 cc Saline by rectal enema or six bisacodyl tablets (Sobhan company) beginning from a day before the operation in order to prepare the bowel. After surgery, surgeons' satisfaction of the surgery and patients' satisfaction of the preparation process were evaluated in the ward using Likert score by a nurse blind to the study. Also, the patients were interviewed for pain after the first defecation, using numeric rating scale based on a 0-10 scores. All patients were actively followed-up after discharge for 1 mo concerning postoperative complications. The obtained data were analyzed by SPSS software (version 16), Mann-Whitney, chi-squared, and Fisher exact tests at the significant level of P < 0/0.5. RESULTS: A total of 79 patients participated in the study, 38 received 500-cc saline by rectal enema and 41 bisacodyl tablets. No significant differences were observed between the two groups in most variables except for pain after the first defecation (P = 0.032). CONCLUSIONS: According to the results, the bisacodyl approach results in less pain in the first postoperative defecation and fewer complications than the rectal enema. Thus, bisacodyl can be suggested as a superior counterpart for enema.