Publications by authors named "Parviz Mardani"

12 Publications

  • Page 1 of 1

Pulmonary hydatidosis genotypes isolates from human clinical surgery based on sequencing of mitochondrial genes in Fars, Iran.

J Cardiothorac Surg 2021 Jun 7;16(1):167. Epub 2021 Jun 7.

Department of Parasitology and Mycology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.

Background: Cystic echinococcosis (CE)/hydatidosis is an important neglected parasitic zoonotic disease caused by the metacestode of Echinococcus granulosus s.l. The present study was designed to identify the pulmonary CE species/genotypes in isolated human underwent to surgery in our center in Southern Iran.

Methods: The study population of this study were all patients in Fars province who were admitted to Namazi Hospitals for pulmonary hydatid cyst surgery. Thoracic surgery was performed in the thoracic ward and the cyst/s was removed by open surgery via posterolateral or lateral thoracotomy. DNA was extracted from the germinal layer or the protoscoleces. PCR technique was performed using the cytochrome C oxidase subunit1 (cox1) gene, and the products were sequenced.

Results: A total of 32 pulmonary hydatid cyst samples were collected from 9 (28%) female and 23 (72%) male aged from 4 to 74 years old. A total of 18(56%) cyst/s were in the left lobe and 14 (44%) cysts in the right lobe. Sequence analysis of the cysts showed that 24 samples (75%) were E. granulosus s.s (G1-G3) genotype and 8 (25%) were E. canadensis (G6/G7) genotype.

Conclusion: E.granulosus s.s genotype was the most prevalent genotype followed by E. canadensis (G6/G7) genotype. There was no significant statistical correlation between cysts' size, location, genotype strain, and patients' age and gender.
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http://dx.doi.org/10.1186/s13019-021-01547-2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8186107PMC
June 2021

Evaluation of Lung Contusion, Associated Injuries, and Outcome in a Major Trauma Center in Shiraz, Southern Iran.

Emerg Med Int 2021 22;2021:3789132. Epub 2021 Apr 22.

Thoracic and Vascular Surgery Research Center, Shiraz University of Medical Science, Shiraz, Iran.

Objective: Blunt chest trauma as one of the most common injuries in trauma cases can cause significant morbidity and mortality. The purpose of this study was to determine the clinical course of traumatic injuries with an initial diagnosis of a pulmonary contusion in patients.

Method: In this retrospective study, we evaluated the demographic and clinical features of patients who were referred to a major trauma center in southern Iran. In our study, patients were enrolled with the diagnosis of pulmonary contusion. All included patients were above 16 years of age, with an initial CT scan in favor of pulmonary contusion, while patients not being hospitalized for more than 48 hours were excluded from the study.

Results: Among the 434 patients included in our study, 366 (84%) were male and the mean age was 41.17 (SD = 17.89). Among them, the majority (80.4%) had right side lung contusion and 47 patients (10.8%) had right rib fracture. The most common injuries were head and neck injury (56.9%) and limbs (30%). In 25% of cases, pulmonary contusion was associated with pneumothorax and 15.8% with hemothorax. Also, 49.6% of patients were transferred to the ICU. The mortality rate in our study was 15.2% ( = 66).

Conclusion: Although recent advances in pulmonary care and ventilator management have been achieved, there is still considerable morbidity and mortality associated with this condition. Therefore, there is a need to provide a national guideline based on native patient information for better management.
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http://dx.doi.org/10.1155/2021/3789132DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8087464PMC
April 2021

Main Bronchus Penetration by Thoracostomy Tube: A Rare Inadvertent Complication.

Bull Emerg Trauma 2021 Jan;9(1):42-45

Thoracic and Vascular Research Center, Shiraz University of Medical Science, Shiraz, Iran.

Tube thoracostomy has been known to be a common and invasive, however not innocuous, procedure which is often life-saving. Though, numerous complications have been reported during executing this procedure. In this report, we describe a 27-year-old woman, case of multiple trauma due to car collision that was transferred to our service due to severe right side chest tube air leak and subcutaneous emphysema in which after proper evaluation, it was revealed that the chest tube crossed through the right pleural cavity and penetrated the bronchus intermedius. A literature search failed to identify a similar case. The misplacement was confirmed by fiber optic bronchoscopy and after surgical and intensive care management of the patient, she was discharged with an uneventful post-op course. This case noticeably determines that bearing in mind the extreme risks and the careful checks of the tube location are required, particularly in trauma patients, even in the absence of anatomical abnormalities.
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http://dx.doi.org/10.30476/BEAT.2020.85839DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8062891PMC
January 2021

Non-operative management of bilateral contained thoracic esophageal perforation: a case report.

BMC Surg 2021 Mar 12;21(1):129. Epub 2021 Mar 12.

Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran.

Background: Despite profound advances in conservative management of esophageal perforation, patients' selection for this type of treatment requires expert clinical judgment. Surgical intervention has been historically introduced as the optimal management in multifocal ruptures.

Case Presentation: Here, we presented a 30-year-old man whose barium esophagogram confirmed bilateral perforations in the lower third of the esophagus contained in the mediastinum, and contrast drained back into the esophageal lumen. Concerning available contrast imaging studies and thoracic surgeons, conservative non-operative management was considered despite pneumomediastinum, a mild right-sided pleural effusion, and minimal leukocytosis. The patient was followed up for two months without any complications.

Conclusions: Bilateral and multifocal esophageal perforations can be managed conservatively provided that the leaks are confined to the mediastinum and drain back to the esophageal lumen, and other criteria for conservative management are met.
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http://dx.doi.org/10.1186/s12893-021-01121-6DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7953744PMC
March 2021

Intrapulmonary mature cystic teratoma of the lung: case report of a rare entity.

BMC Surg 2020 Sep 14;20(1):203. Epub 2020 Sep 14.

Thoracic and Vascular Surgery Research Center, Shiraz University of Medical Science, Shiraz, Iran.

Background: Intrapulmonary teratoma (IPT) is a rare type of extra gonadal teratoma which often presents with non-specific symptoms and can be misdiagnosed as other diseases. Here we report a patient with IPT which was initially misdiagnosed as lung hydatid cyst versus abscess.

Case Presentation: We report an intrapulmonary teratoma in a 27-year-old female presenting with persistent chest pain and dyspnea since a few years prior to her admission with associated symptoms of cough and fever. Chest x-ray only showed left side massive pleural effusion and computed tomography scan of the lungs was suggestive of hydatid cyst or a lung abscess. She underwent lobectomy and postoperative histopathological study revealed IPT as the final diagnosis.

Conclusion: Due to the non-specific symptoms and rarity, IPT can be easily misdiagnosed at first. It is essential that physicians take into account the possibility of IPT when approaching a new case of lung mass.
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http://dx.doi.org/10.1186/s12893-020-00864-yDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7491125PMC
September 2020

Masson's Tumor of the Hand: An Uncommon Histopathological Entity.

Case Rep Pathol 2020 18;2020:4348629. Epub 2020 Mar 18.

Department of Pathology School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.

Masson's tumor or Masson's hemangioma, more precisely termed intravascular papillary endothelial hyperplasia (IPEH), is an uncommon benign vascular lesion of the skin and subcutaneous tissues which can be frequently confused with angiosarcoma. Although relatively rare, its accurate diagnosis is essential since it can clinically be similar to both benign and malignant lesions. We present a 39-year-old man with a round bulging arising from the left palm side of the hand with gradual growth in the last 5 months and on and off tenderness. The microscopic section demonstrated the papillary proliferation of endothelial cells in favor of Masson's hemangioma, which was sufficiently treated with excision alone.
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http://dx.doi.org/10.1155/2020/4348629DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7136786PMC
March 2020

Massive hemoptysis following cannulation of right internal jugular vein for insertion of cuffed hemodialysis catheter: A rare complication of central venous catheterization.

J Vasc Access 2021 Jan 6;22(1):154-157. Epub 2020 Mar 6.

Thoracic and Vascular Surgery Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.

Here we report an extremely rare presentation of internal jugular vein catheterization, presenting as massive hemoptysis which was noted during right internal jugular vein cuffed hemodialysis catheter insertion of a 39-year-old man known-case of End-Stage Renal Disease. Chest roentgenogram and computerized tomography scan showed pleural effusion and misplacement of the tip of hemodialysis catheter in the posterior mediastinum causing possible damage to the right main bronchus. After chest tube insertion and removing the misplaced hemodialysis catheter, a proper cuffed catheter was inserted and the patient was discharged with an uneventful post-op course.
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http://dx.doi.org/10.1177/1129729820910304DOI Listing
January 2021

First Iranian Experience of the Minimally Invasive Nuss Procedure for Pectus Excavatum Repair: A Case Series and Literature Review.

Iran J Med Sci 2018 Sep;43(5):554-559

General Thoracic Surgeon, General Thoracic Surgery Ward, Tehran University of Medical Sciences, Tehran Iran.

Pectus excavatum is the most common congenital deformity of the chest wall. The most frequently used techniques include Ravitch (costochondral resection) and Nuss (minimally invasive pectus repair of pectus excavatum [MIRPE]). The Nuss technique includes using temporary metallic bars without costochondral resection to correct the chest wall deformity. Modified MIRPE can be learned easily and performed safely with few complications. There are no reports of successful MIRPE in Iran, although the Ravitch technique is well known. In the present study, we report the first Iranian experience with the modified Nuss procedure in 5 patients with pectus excavatum (age range=13-48 y). All the patients suffered from low self-esteem, and one of them complained of low exercise capacity and occasional chest pain. With single-lung ventilation and sternal elevation, an introducer was entered into the right thoracic cavity and retrosternal tunneling was performed under thoracoscopic vision. The introducer was passed to the left thoracic cavity and exited on the left thoracic wall. A titanium plate bar was implanted and fixed with stabilizers. There were no cases of mortality, and all the patients were discharged in good conditions within 2 weeks. Postoperative complications consisted of 1 case of pneumothorax and 2 cases of fixed bar protrusion. The present case series indicated that a skilled thoracoscopic surgeon is able to do the Nuss procedure in Iranian patients with symmetrical pectus excavatum with few complications. However, mixed or redo cases require more expertise.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6123557PMC
September 2018

Which One is Better? Comparison of the Acute Inflammatory Response, Raja Isteri Pengiran Anak Saleha Appendicitis and Alvarado Scoring Systems.

Ann Coloproctol 2017 Dec 31;33(6):227-231. Epub 2017 Dec 31.

Student Research Committee, Faculty of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.

Purpose: Acute appendicitis (AA) is one of the most common causes of an acute abdomen. The accuracies of the Alvarado and the acute inflammatory response (AIR) scores in the diagnosis of appendicitis is very low in Asian populations, so a new scoring system, the Raja Isteri Pengiran Anak Saleha Appendicitis (RIPASA) system, was designed recently. We applied and compared the Alvarado, AIR, and RIPASA scores in the diagnoses of appendicitis in the Iranian population.

Methods: We prospectively compared the RIPASA, Alvarado, and AIR systems by applying them to 100 patients. All the scores were calculated for patients who presented with right quadrant pain. Appendectomies were performed; then, the postoperative pathology reports were correlated with the scores. Scores of 8, 7, and 5 or more are optimal cutoffs for the RIPASA, Alvarado, and AIR scoring systems, respectively. The sensitivities, specificities, positive predictive values, negative predictive values (NPVs), positive and negative likelihood ratios (LRs) for the 3 systems were determined.

Results: The sensitivity and the specificity of the RIPASA score were 93.18% and 91.67%, respectively. The sensitivities of the Alvarado and the AIR scores were both 78.41%. The specificities of the Alvarado and the AIR scores were 100% and 91.67%, respectively. The RIPASA score correctly classified 93% of all patients confirmed with histological AA compared with 78.41% for the Alvarado and the AIR scores.

Conclusion: The RIPASA scoring system had more sensitivity, better NPV, a positive LR, and a less negative LR for the Iranian population whereas the Alvarado scoring system was more specific.
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http://dx.doi.org/10.3393/ac.2017.33.6.227DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5768477PMC
December 2017

A Primary Pleural Hydatid Cyst in an Unusual Location.

Tanaffos 2017 ;16(2):166-169

Department of Surgery, Shiraz University of Medical Sciences, Shiraz, Iran.

Hydatid cyst has a predilection to involve the liver and lungs. Most of the reported cases of intra-pleural hydatid cyst are secondary; primary involvement has rarely been reported in the English-language literature. Here, we report on a 33-year-old woman who presented with complaints of dyspnea, cough, low-grade fever, and chills over the previous 3 months. Primary pleural hydatidosis was suspected on abdominopelvic CT; hence, right thoracotomy and cystectomy were performed. Albendazole was administered postoperatively for 6 months. During this period, liver function tests and abdominal sonography results were normal. Despite its rarity, our case emphasizes that general surgeons should suspect primary hydatidosis of the plural cavity when they detect large cystic masses in patients with mediastinal shifting and radiography findings such as white lung, especially in patients with fever and dyspnea.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5749330PMC
January 2017

Traumatic Aneurysm of Innominate Artery Resulting in Tracheal Stenosis and Rapidly Progressive Respiratory Failure; A Case Report and Literature Review.

Bull Emerg Trauma 2015 Jul;3(3):111-3

Department of Surgery, Shiraz University of Medical Sciences, Shiraz, Iran.

Traumatic injuries to great vessels are relative common in trauma practice. Blunt thoracic trauma may result in dissection injury to aorta and innominate artery. We herein present a late presentation of traumatic innominate artery aneurysm. A29-year-old woman presented with dyspnea to our emergency department. She had previous motor-vehicle accident a month before presentation for which had undergone chest tube insertion. She was diagnosed to have traumatic aneurysm of innominate artery resulting in tracheal stenosis resulting in acute life threatening respiratory failure. She underwent simultaneous aneurysm resection and tracheal reconstruction. She was uneventfully discharged from hospital. Any post-traumatic respiratory and cardiovascular symptoms may propound an undiagnosed serious injury to the great vessels. Extra and repetitive imaging studies may help us in better evaluation of traumatized patients with high energy mechanisms and sharp injuries to chest and neck.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4771251PMC
July 2015

Reduction of the severity of ischemia reperfusion-induced pancreatitis by ischemic pre-conditioning of the liver.

Saudi J Kidney Dis Transpl 2009 Nov;20(6):1010-4

Department of Surgery, University of Shiraz Medical Sciences and Health Services, Transplantation Research Centre, Shiraz, Iran.

Pre-conditioning by brief exposure to ischemia does not only protect the concerned organ against subsequent severe ischemic damage, but also has protective effect on other organs, which is called remote pre-conditioning. Our aim in this study was to evaluate the protective effect of brief liver ischemia on the pancreas against severe ischemia-reperfusion-induced pancreatitis. This study was performed on 30 male Wistar rats. Ischemic pre-conditioning of liver was performed by first clamping of the hepatic pedicle for 10 minutes. Following this, ischemia-reperfusion of the pancreas was performed by first clamping the inferior splenic artery for 30 minutes, followed by reperfusion for one hour. The rats were divided into three groups (10 rats in each group). Group one was the sham operated group, without clamping of any artery. Group two developed ischemia-reperfusion-induced pancreatitis, without ischemic pre-conditioning of the liver, while Group three underwent ischemic pre-conditioning of the liver followed by ischemia-reperfusion of the pancreas. Ischemic pre-conditioning, applied prior to induction of pancreatitis, caused a reduction in plasma lipase, plasma interleukin-1beta and histological signs of pancreatic damage, but plasma interleukin-10 levels were not significantly different between the three groups. Ischemic pre-conditioning of the liver did not cause any alteration of the liver enzymes. Our study suggests that ischemic pre-conditioning of the liver reduces the severity of ischemia-reperfusion-induced pancreatitis. These effects are partly related to the reduction of pro-inflammatory interleukin -1beta.
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November 2009
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