Publications by authors named "Hamid Reza Jabardarjani"

4 Publications

  • Page 1 of 1

Diagnostic Value and Effective Factors on Transbronchial Lung Biopsy Using Cup and Alligator Forceps.

Tanaffos 2016 ;15(3):128-133

Tracheal Diseases Research Center, NRITLD, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Background: Lung biopsy through the airways by using a flexible bronchoscope (transbronchial lung biopsy: TBLB) is a suitable method for obtaining tissue specimens. This study aimed at evaluating the factors influencing TBLB results in order to increase the diagnostic power of this method.

Materials And Methods: This was a prospective double blind observational study. We had a total of 44 patients with pulmonary lesions who underwent biopsy and 4 specimens were obtained from each patient. A total of 176 specimens were obtained from all patients. Biopsy specimens were taken using cup and alligator forceps alternatively. Characteristics of the obtained specimens including size, floatation, alveolarity, and bleeding were thoroughly studied. After sending to the pathologist, specimens were divided into 2 groups of diagnostic and non-diagnostic specimens.

Results: Of a total of 176 specimens, 37 (21%) were diagnostic and 139 (79%) were non-diagnostic. From 88 specimens obtained by the alligator forceps, 16 were diagnostic while from the same number of specimens taken by the cup forceps 21 had diagnostic value. However, this difference was not statistically significant (P>0.05). Of the small specimens (57 cases), 12 (21.1%) were diagnostic while among the 66 medium specimens, 12 (18.2%) and from the 53 large specimens, 13 (24.5%) were diagnostic. No statistically significant difference was detected in this respect (P>0.05). Among specimens floating on the surface of the liquid (48 cases), 6 (12.5%) had diagnostic value. Of the 12 specimens suspended in the liquid, 2 (16.7%) and among the 116 specimens precipitated at the bottom, 29 (25%) were diagnostic. These differences were not significant either (P>0.05). Of the 84 specimens with more than 20 alveoli, 31 (36.9%) were diagnostic. Among 26 specimens with less than 20 alveoli 5 (19.2%) were diagnostic. This correlation was statistically significant indicating that the higher the number of alveoli in the biopsy specimen, the greater the chance of being diagnostic.

Conclusion: This study failed to find a significant correlation between the diagnostic power of TBLB and type of forceps, sample size or floatation of the specimen in the liquid. However, number of alveoli present in the tissue specimens was significantly correlated with its diagnostic value. Increasing the number of specimens to four can increase the chance of diagnosis.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5304955PMC
January 2016

Tracheal Stenosis and Cuff Pressure: Comparison of Minimal Occlusive Volume and Palpation Techniques.

Tanaffos 2015 ;14(4):252-6

Tracheal Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Background: Tracheal stenosis, which has received more emphasis recently, is a common post intubation complication and may develop due to different reasons. One important reason is the endotracheal tube cuff pressure. Therefore, this study sought to examine the accuracy of diagnostic test for palpation and minimal occlusive volume techniques to measure the endotracheal tube cuff pressure.

Materials And Methods: In this cross sectional study, the accuracy of diagnostic tests for palpation and minimal occlusive volume techniques to measure the endotracheal tube cuff pressure was assessed in 101 patients aged over 18 years who had undergone open heart surgery and post-surgical mechanical ventilation in the ICU.

Results: In the palpation technique, the cuff pressure of 27 patients (26.7%) was reported to be out of the permissible range and for the rest of them (74 patients, 73.3%) it was within the permissible range. Then, the cuff pressure was checked by the standard method using a manometer and after comparing the results it was found that the cuff pressure of 92 patients (91.1%) was not in the permissible range and only nine patients (8.9%) had a cuff pressure within the permissible range (20-30 cm H2O). In minimal occlusive volume method compared with the standard method, 22 patients (21.7%) had cuff pressure within the permissible range of 20-30 cm H2O, and 79 of them (78.2%) had cuff pressure out of the permissible range and higher than the upper limit.

Conclusion: This study recommends that the best way to measure the endotracheal tube cuff pressure is to use a cuff manometer, and when it is not available, the minimal occlusive volume would be a better alternative compared to the palpation technique to keep the cuff pressure within a proper range to avoid tracheotomy complications such as tracheal stenosis.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4841992PMC
April 2016

Diagnostic Yield of Medical Thoracoscopy in Undiagnosed Pleural Effusion.

Tanaffos 2015 ;14(4):227-31

Chronic Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Disease (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Background: One of the most common indications for pleuroscopy is undiagnosed pleural effusion, which comprises about 25% of all cases of pleural effusions, which remain undiagnosed despite primary tests. Pleuroscopy was performed for the first time in Iran in Masih Daneshvari hospital located in Tehran. The aim of this study was to assess the diagnostic yield of pleuroscopy performed in this center in Iran.

Materials And Methods: Three-hundred patients with undiagnosed pleural effusions were enrolled in this study. For all patients, primary tests including pleural effusion analysis, cytology and closed pleural biopsy (if needed) were conducted and all of them were inconclusive. The semirigid thoracoscopy (pleuroscopy) was performed for all patients for diagnostic purposes.

Results: Eighty-seven percent of the peluroscopies were diagnostic and 67% of them were diagnosed as malignancy while the rest were diagnosed as tuberculosis. Only 11 patients developed minor complications.

Conclusion: In conclusion, pleuroscopy is a safe procedure when performed by a skilled and experienced practitioner; it has a high diagnostic yield and results in only minor complications.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4841988PMC
April 2016

Evaluation of bronchoscopy complications in a tertiary health care center.

Tanaffos 2014 ;13(4):48-50

Chronic Respiratory Diseases Research Center, NRITLD, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Background: Bronchoscopy is a technique of visualizing the inside of the airways for diagnostic and therapeutic purposes. This study was performed to determine the complications of bronchoscopy in a tertiary health-care center.

Materials And Methods: This study had as descriptive cross sectional design. Four hundred adult patients between 16 to 85 years, who underwent bronchoscopy with a same method and same device and had no underlying disease, were consecutively enrolled.

Results: Bronchoscopy complications were seen in 13 patients (3.25%) including bleeding (four cases), pneumothorax (three cases), collapse (four cases), and infection (two cases). There was no association between complications and age, sex, bronchoscopy indications and findings (P > 0.05).

Conclusion: According to the obtained results, it may be concluded that bronchoscopy can be performed safely whenever indicated. Complications occurred were minor and self limiting.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4386015PMC
April 2015