Publications by authors named "Mohammadreza Mobayen"

10 Publications

  • Page 1 of 1

The presentation of spontaneous splenic rupture in a COVID-19 patient: a case report.

BMC Surg 2020 Oct 2;20(1):220. Epub 2020 Oct 2.

Department of General Surgery, Guilan University of Medical Sciences, Rasht, Iran.

Background: Splenic rupture is an emergency condition and a vast number of cases are secondary to trauma. Several underlying pathologies have also been associated with splenic rupture, such as hematological diseases, malignancies, and infectious and inflammatory diseases.

Case Presentation: The patient was a 52-year-old man who referred to the Poursina Hospital in Rasht while complaining of abdominal pain from the day before hospitalization. The patient reported a history of lethargy, fever, and nausea. In the examinations performed, there was a brief tenderness in the patient's epigastrium. The patient was monitored and about 12 h after hospitalization, ill appearance, respiratory (respiratory distress) symptoms, and high fever were reported for the patient. According to the examination, the patient was immediately transferred to the operating room and underwent laparotomy. During the operation, contrary to our expectations, a lot of blood (about 1000 cc) was observed in the patient's abdomen. After blood suctioning, the left upper quadrant (LUQ) was bleeding and the rupture of the spleen could also be observed. Therefore, a splenectomy was performed. In the examinations performed for the patient, the patient's rtPCR test confirmed COVID-19.

Conclusion: The evaluation of the spontaneous splenic rupture (SSR) in our case shows that this type of risk should also be considered in patients with COVID-19 who refer to medical centers with abdominal pain, and if more cases are reported, the correctness of this process can be commented on.
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http://dx.doi.org/10.1186/s12893-020-00887-5DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7530872PMC
October 2020

Changes in serum phosphorus level in patients with severe burns: A prospective study.

Burns 2019 12 2;45(8):1864-1870. Epub 2019 Nov 2.

Guilan Road Trauma Research Center, Guilan University of Medical Sciences, Rasht, Iran.

Background: The second most abundant mineral in the body, phosphorus (P), is absorbed in the small intestine after ingestion enhanced by 1,25-dihydroxy vitamin D, and its excretion is exclusively regulated by the kidney. It is clinically significant, aside from its disturbance in burn ICU patient's P mechanism. The increasing rate of morbidity and mortality among the patients can be associated with severe hypophosphatemia. The current study aimed at investigating the changes in serum P levels in the early period after burns, the relationship between serum P level and TBSA (total body surface area) of burn, and the impact of hypophosphatemia on patients' clinical outcomes.

Material And Methods: The current prospective, observational study was conducted on 137 patients hospitalized in the burn intensive unit (BICU) of Velayat Sub-specialty Burn and Plastic Surgery Center from December 2015 to May 2017. According to the TBSA percentage, the patients were divided into three groups. The level of serum P was determined in the 1st, 3rd, 5th, 7th, and 9th days of hospital stay and before discharge. To evaluate the trend of P changes in the sixtime-points, the average changes along with 95% confidence intervals (CI) were used for multivariate analysis of variance with repeated measures (repeated measures ANOVA). A P-value of 0.05 or less was considered statistically significant. The analyses were performed using SPSS software, version 19 (SPSS Inc.).

Results: Totally, 137 patients (70% male, mean age 32 ± 21years, and TBSA 32.6 ± 14%) were included in the study. The overall incidence of hypophosphatemia was 75.1%. Hypophosphatemia developed as early as 1.66 ± 0.136 (95%CI: 1.4-1.9) days after injury. The highest decrease in the serum P level was observed on the 3rd and 5th days after burn as 2.78 mg/dL and 2.85 mg/dL, respectively (P-value = 0.001). A correlation was observed between TBSA and serum P level. The mean serum P level decreased with increasing the percentage of burns. There was a correlation between serum P level and mortality; therefore, a decrease in serum P level increased the patient's mortality rate (P < 0.05).

Conclusion: The current study highlighted that hypophosphatemia is often observed in patients with burn injuries during their hospitalization. It is potentially beneficial to identify patients at risk of hypophosphatemia. Therefore, it is suggested that P level be assessed regularly in patients with burn injuries for the timely initiation of P replacement therapy.
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http://dx.doi.org/10.1016/j.burns.2019.03.015DOI Listing
December 2019

Comparison of the results of total thyroidectomy and Dunhill operation in surgical treatment of multinodular goiter.

Indian J Surg 2015 Dec 24;77(Suppl 3):1137-41. Epub 2015 Mar 24.

Student Research Committee, Guilan University of Medical Sciences, Rasht, Iran.

Multi-nodular goiter (MNG) is one of the commonest thyroid gland disease. Surgery is an important treatment option in the presence of indications. There are several alternative procedures for thyroid gland operation such as subtotal thyroidectomy (STT), near-total thyroidectomy (NTT), hemi-thyroidectomy plus subtotal resection (Dunhill procedure), and total thyroidectomy (TT), but the surgical procedure of choice is still under discussion. In this study, 173 consecutive patients with multi-nodular goiter underwent thyroid operation in the department of surgery of Pursina Hospital in Rasht-Iran, using two different methods: Dunhill operation and total thyroidectomy. Outcome assessment was performed 4 days after surgery, 2 weeks, 1, 2, 10, and 20 month after surgery. Preoperative assessment, seroma, recurrent laryngeal nerve palsy, hypocalcaemia rates, and rates of other postoperative complications, final pathology, and recurrence were compared in two methods. Due to the high incidence of malignancy in this survey, TT can be the method of choice for MNG surgery. Also, TT will be more beneficial in the surgical treatment of benign thyroid disorders, especially those which are bilateral or extended to substernal space or which presented with compression symptoms.
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http://dx.doi.org/10.1007/s12262-015-1213-zDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4775626PMC
December 2015

Colonization of Mycoplasma hominis and Ureaplasma urealyticum in pregnant women and their transmission to offspring.

Iran J Microbiol 2014 Aug;6(4):219-24

Shahid Motahari Burn Research Center, Iran University of Medical Sciences, Tehran, Iran.

Background And Objectives: Mycoplasma hominis and Ureaplasma urealyticum are important opportunistic pathogens that cause urogenital infections and accelerated newborn delivery in pregnant women. Moreover genital mycoplasmas have been implicated in different neonatal diseases such as pneumonia, sepsis and meningitis. This study was conducted to find out the prevalence and transmission rate of these two organisms in pregnant women and their neonates.

Materials And Methods: Nasotracheal and pharyngeal specimens of 165 newborns hospitalized at Neonatal Intensive Care Unit (NICU) of Rasoul Akram Hospital (during 2010 - 2011) were assessed by PCR to detect M. hominis and U. urealyticum. Moreover, PCR of vaginal specimens from their mothers were obtained to determine the prevalence of these organisms in pregnant women and rate of transmission to their newborns. Data were analyzed using SPSS software.

Results: Totally, the results of PCR were positive in 33 newborns (20%). Vaginal colonization among the mothers was found to be 15% (25/165) for U. urealyticum and 15% (25/165) for M. hominis. The transmission rate to their infants was 72% and 60% for U. urealyticum and M. hominis, respectively.

Conclusion: These data indicate that vertical transmission of mycoplasma and ureaplasma are prevalent in newborns. Since these organisms cause serious infections in neonates, it would be better to perform screening tests in pregnant women before the delivery in order to prevent transmission to neonates and consequent infections and morbidities among them.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4367936PMC
August 2014

Survey of 2582 cases of acute orthopedic trauma.

Trauma Mon 2014 Nov 10;19(4):e16215. Epub 2014 Sep 10.

Department of Orthopedics, Poursina Hospital, Guilan University of Medical Sciences, Rasht, IR Iran.

Background: Orthopedic injuries are among the most common causes of mortality, morbidity, hospitalization, and economic burden in societies.

Objectives: In this research, we study the prevalence of different types of trauma requiring orthopedic surgery.

Patients And Methods: We conducted a cross-sectional study on 2582 patients with acute orthopedic injuries admitted to the orthopedic emergency ward at the Poursina Hospital (a referral center in Guilan province (northern Iran), during December 2010 through September 2011. Patients were examined and the data collection form was filled for each patient. Data were analyzed by SPSS software version 19 and were listed in tables.

Results: Of 2582 included cases, 1940 were male and 642 were female, with a mean age of 34.5 years. Most injuries were seen in the 25 to 44 year age group from rural areas. The highest frequency of trauma related to falls. On the other hand, bicycling and shooting had the lowest frequencies. There were 18 cases with limb amputation. Overall, 66.5% of patients had fractures, 5% had soft tissue lacerations, and 10% had dislocations.

Conclusions: Identification of risk factors and methods of prevention is one of the most important duties of healthcare systems. Devising plans to minimize these risk factors and familiarizing people with them is prudent.
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http://dx.doi.org/10.5812/traumamon.16215DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4310155PMC
November 2014

Management of Hypertrophic Burn Scar: A Comparison between the Efficacy of Exercise-Physiotherapy and Pressure Garment-Silicone on Hypertrophic Scar.

Asian J Sports Med 2013 Mar 30;4(1):70-5. Epub 2012 Sep 30.

Department of Plastic and Reconstructive Surgery, Motahari Burn Hospital, Tehran University of Medical Sciences, Tehran, Iran.

Purpose: Our study aims to investigate the effectiveness of other treatment methods for burn related scarring and to determine the possibility of their routine administration in similar clinical settings.

Methods: Through a prospective study, 66 patients were enrolled to receive either the conventional pressure garment therapy (PGT) and Silicone (control group) or exercise and physiotherapy (case group). Patients were visited regularly to be examined for the status of their scars' regression, limbs' dysfunction, and joint motion. Then, these two groups were compared to determine the efficacy of exercise and physiotherapy as an alternative to the conventional treatment with PGT.

Results: After about 20 months follow-up, decreased articular range of motion (ROM) was: 16 (51.5%) cases compared to 5 (15%) of controls had mild, 11 (35.5%) of the cases compared to 13 (39.5%) of the controls had moderate; and 4 (13%) of the cases compared to 15 (45.5%) of the controls had severe decreased ROM which revealed statistically significant difference (P<0.01). At the same time, Vancouver Scar Scale score was: 15 (48%) of the cases and 6 (18%) of the controls had mild Scar Scale, 12 (39%) of the cases and 14 (42.5%) of the controls had moderate score and 4 (3%) of the cases and 13 (39.5%) of the controls had severe score which revealed a statistically significant difference (P<0.05).

Conclusion: Our study showed that physical therapy andexercise are more effective than PGT, in management of burn hypertrophic scar, hence could be an alternative in cases that conventional therapy cannot be used for any reason.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3685163PMC
http://dx.doi.org/10.5812/asjsm.34536DOI Listing
March 2013

Prediction of mortality in pediatric burn injuries: R-baux score to be applied in children (pediatrics-baux score).

Iran J Pediatr 2013 Apr;23(2):165-70

Department of Plastic and Reconstructive Surgery, Motahari Burn Hospital, Tehran University of Medical Sciences, Tehran, Iran.

Objective: R-Baux score has obtained an acceptable validity and accuracy in predicting burn-related mortality. However, its usage and efficacy among pediatric burn patients has not been well documented. The aim of this study was to employ Pediatrics-Baux (P-Buax) score as modified version of R-Baux score in these patients to determine how it could be applicable in this population.

Methods: Through a prospective study, 870 pediatric burn patients were enrolled. P-Baux and R-Baux scores were calculated for each patient and they were categorized to different groups according to these scores. Mortality and further death probability were measured for each subject and then analyzed by logistic regression model to reveal how they change in relation with age in pediatric burn patients.

Findings: R-Baux score for 95% probability of death revealed a mean of 73 among patients of this study. Also P-Baux score was measured in these patients with inhalation injury which showed to be 55 for 95% probability of death. Results showed that age had a positive prognostic value in contrast to the negative prognostic value of Total Body Surface Area (TBSA) and inhalation injury.

Conclusion: Our analysis showed that in children under the age of 15 years, age has a positive prognostic value while TBSA and inhalation injuries had negative prognostic values in relation to mortality. Hence, in contrast to the adult population, burn injury related mortality may be predicted by modified R-Baux score as (TBSA - age + [18×R]) which could be named as P-Baux score.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3663307PMC
April 2013

Prediction of mortality in pediatric burn injuries: R-baux score to be applied in children (pediatrics-baux score).

Iran J Pediatr 2013 Apr;23(2):165-70

Department of Plastic and Reconstructive Surgery, Motahari Burn Hospital, Tehran University of Medical Sciences, Tehran, Iran.

Objective: R-Baux score has obtained an acceptable validity and accuracy in predicting burn-related mortality. However, its usage and efficacy among pediatric burn patients has not been well documented. The aim of this study was to employ Pediatrics-Baux (P-Buax) score as modified version of R-Baux score in these patients to determine how it could be applicable in this population.

Methods: Through a prospective study, 870 pediatric burn patients were enrolled. P-Baux and R-Baux scores were calculated for each patient and they were categorized to different groups according to these scores. Mortality and further death probability were measured for each subject and then analyzed by logistic regression model to reveal how they change in relation with age in pediatric burn patients.

Findings: R-Baux score for 95% probability of death revealed a mean of 73 among patients of this study. Also P-Baux score was measured in these patients with inhalation injury which showed to be 55 for 95% probability of death. Results showed that age had a positive prognostic value in contrast to the negative prognostic value of Total Body Surface Area (TBSA) and inhalation injury.

Conclusion: Our analysis showed that in children under the age of 15 years, age has a positive prognostic value while TBSA and inhalation injuries had negative prognostic values in relation to mortality. Hence, in contrast to the adult population, burn injury related mortality may be predicted by modified R-Baux score as (TBSA - age + [18×R]) which could be named as P-Baux score.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3663307PMC
April 2013

Epidemiology of burn injuries at a newly established burn care center in rasht.

Trauma Mon 2012 10;17(3):341-6. Epub 2012 Oct 10.

Burn Research Center, Tehran University of Medical Sciences, Tehran, IR Iran.

Background: Advances in the care of burn injuries have resulted from the efforts of regional patient-based specialist teams at burn care centers.

Objectives: We conducted this study to assess the four-year epidemiology of burn injuries in Rasht, Iran.

Materials And Methods: In this cross-sectional study, medical records of 2274 burn patients, treated at Velayat hospital from January 2007 to December 2010 in Rasht, Iran, were assessed. Age, sex, level of education, occupation, severity and degree of burn, burn surface area, burn cause and outcome of patients were evaluated.

Results: In our study the overall mortality rate was 8.7%; 65.7% of patients were men and 34.3% were women. Mean age of patients was 31.47 ± 22.67 years. Mean Total Burn Surface Area (TBSA) was 15.24 ± 18.4. Lowest TBSA was 0.5% and highest TBSA was 100%. Significant associations were observed between age (P = 0.0001), place of residence (P = 0.004), level of education (P = 0.0001), unemployment (P = 0.0001), marital status (P = 0.021), causes of burn (P = 0.0001), TBSA (P = 0.0001) and mortality rate. In our study, no significant difference was observed between age and sex (P = 0.071).

Conclusions: Due to high prevalence of burn injuries in Iran, increasing the level of awareness of the society as well as adhering to safety procedures both at home and workplace is recommended via implementing effective national safety policies.
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http://dx.doi.org/10.5812/traumamon.6991DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3860622PMC
December 2013

A comparative study of cardioprotective effect of three anesthetic agents by measuring serum level of troponin-T after coronary artery bypass grafting.

Int Cardiovasc Res J 2012 Sep 15;6(3):70-4. Epub 2012 Sep 15.

Department of Burn Surgery, Motahari Burn Hospital, Rasht University of Medical Sciences, Tehran, IR Iran.

Background: Cardiac surgery is associated with some degree of myocardial injury. Preconditioning first described in 1986 was pharmacologic and non- pharmacologic. Among the long list of anesthetic drugs, isoflurane as an inhaling agent along with midazolam and propofol as injectable substances have been documented to confer some preconditioning effects on myocardium.

Objectives: In this study cardiac Troponin T (cTnT) ,as a reliable marker, was used for evaluating myocardial injury.

Methods: This prospective double blind study was comprised of 60 patients scheduled for CABG and were randomly assigned into three groups who received infusion of propofol or midazolam or isoflorane. Surgical procedures and anesthetics were similar for 3 groups. cTnT measured preoperatively and at 12, 24 and 36hr after arrival in ICU.

Results: There were no statistically significant differences in mean cTnT levels between three groups in the preoperative period and 12-24 hours after arrival in ICU. However, mean cTnT in 3 groups at 36 hours after arrival in ICU were different (P< 0.013) and cTnT level was significantly higher in midazolam group (P<0.001) and lowest in isoflurane group (P=0.002).

Conclusion: There were significant differences on cTnT levels between anesthetic groups of isofluran, midazolam and propofol at 36 hr after surgery. Preconditioning effect of isoflurane was higher than the other two groups.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3987406PMC
September 2012