Positive End-Expiratory Pressure in Rhinoplasty Surgery; Risks and Benefits.

Aims: The aim of this study is to evaluate the effect of Positive End Expiratory Pressure (PEEP) on surgical field bleeding and its respiratory and hemodynamic consequences in rhinoplasty surgeries. Materials and methods: This single-blind clinical trial performed in Amir Al-Momenin university Hospital in 2018. Seventy cases of rhinoplasty surgery patients Enrolled and were randomized into two groups; intervention (PEEP = 5) and comparison group (PEEP = 0). Surgical field bleeding and arterial oxygen saturation pulmonary dynamics and hemodynamic parameters were evaluated during operation and in post anesthesia care unit. Data were analyzed by SPSS software using descriptive and analytical statistics. Results: PEEP applying had no negative effect on surgical bleeding as well as surgeon satisfaction, heart rate and blood pressure were similar in two groups. Pulmonary dynamics and oxygenation were stable and within normal values in all cases. The mean peak airway pressure was 17.87 ± 2.24 in the PEEP group and 16.08 ± 3.37 in the ZEEP group (P = 0.029). Conclusion: applying low level PEEP during anesthesia improved recovery oxygen saturation but had no negative effects on the patient`s hemodynamics, and did not aggravate bleeding and visual clarity. Supplementary Information: The online version contains supplementary material available at 10.1007/s12070-023-03854-7.

Epidemiologic Features of Inflammatory Bowel Disease in Guilan Province, North of Iran, During 2002-2012.

BACKGROUND The geographical incidence of IBD varies considerably. This study aimed to survey the epidemiologic features of IBD in Guilan province, North of Iran, during ten years duration. METHODS In this retrospective cross-sectional study, we assessed the documents of 868 patients with IBD referred to private and governmental clinics of Guilan province between 2002 and 2012. Variables such as demographic data, risk factors, diagnosis, extraintestinal manifestations and type of treatment were collected. RESULTS Among 868 patients with IBD, 756 patients (87.1%) diagnosed as UC and 112 patients (12.9%) as CD. The mean age of patients with UC and CD was 46.73±15.79 and 40.15±14.27 years respectively. Male/female ratio in UC and CD was 0.92:1 and 0.75:1 respectively. The most common age of disease initiation in UC was 40-59 years and in CD 20-39 years (p<0.001). Extraintestinal manifestations were seen in 25.4 percent of patients with IBD. Most of patients were treated with combination of two drugs: salicylates and azathioprine (p<0.04). The incidence of IBD gradually increased during the past 4 years in Guilan province. CONCLUSION This study showed that CD were presented significantly more common in younger patients than UC and totally the disease was slightly more common in female.