Background:Uncontrolled postoperative pain, characteristic to abdominal hysterectomy, results in multiple complications. One of the methods for controlling postoperative pain is preemptive analgesia. Gabapentin and tramadol are both used for this purpose.Objectives:This study aims to compare the effects of tramadol and gabapentin, as premedication, in decreasing the pain after hysterectomy.Patients and Methods:This clinical trial was performed on 120 eligible elective abdominal hysterectomy patients, divided in three groups of 40, receiving tramadol, gabapentin and placebo, respectively. Two hours before the surgery, the first group was given 300 mg gabapentin, the second one was given 100 mg tramadol, while the other group was given placebo, with 50 ml water. After the surgery, in case of visual analog pain scale (VAS) > 3, up to 3 mg of diclofenac suppository would be used. Pain score, nausea, vomiting, sedation, patient’s satisfaction and the number of meperidine administered during 24 hours (1 - 4 - 8 - 12 - 16 - 20 - 24 hours) were recorded. If patients had VAS > 3, despite using diclofenac, intravenous meperidine (0.25 mg/kg) would be prescribed. Data were analyzed using SPSS 21 software, chi-square test, general linear model and repeated measurement.Results:The three groups were similar regarding age and length of surgery (up to 2 hours). The average VAS, in the placebo group, was higher than in the other two groups (P = 0.0001) and the average received doses of meperidine during 24-hour time were considerably higher in placebo group, compared to the other two groups (55.62 mg in placebo, 18.75 mg in gabapentin and 17.5 mg in tramadol groups, P = 0.0001). Nausea, vomiting and sedation, in the tramadol group, were higher than in the other two groups, although they were not significant. Patients’ dissatisfaction, in the placebo group, during initial hours, especially in the fourth hour, was higher (P = 0.0001). In the gabapentin and tramadol groups, the trend of changes in satisfaction score was similar. However, satisfaction in the gabapentin group, during the initial 4 hours was higher, in comparison to the tramadol group (P = 0.0001).Conclusions:This study revealed that prescribing gabapentin or tramadol, as premedication, was effective in reducing postoperative pain, without any concerning side-effects.
Background: Screening programs for the early diagnosis of breast cancer lead to perform several biopsies in order to determine the breast abnormalities found in sonography and mammography. According to gradually replacement of core needle biopsy instead of more invasive methods like open surgical biopsy, it seems necessary to study the concordance between biopsy results and non-invasive diagnostic methods in order to clarify ambiguous results and confirm the reliability of non-invasive methods. Objective: The objective of this study was to match the sonography and mammography reports with core needle biopsy in patients referred to Sahand core needle biopsy center. Materials and methods: This prospective cross-sectional study was performed on 240 patients referred to Sahand Center with sonography or mammography reports or by a surgeon for core needle biopsy. All the patients were examined by a gynecologist assistant and were asked about demographic information and their recent diseases. The matched sonography or mammography cases with pathology reports and positive predictive value based on comparison between them and pathology report were determined as standard diagnostic criteria. Then, data were statistically analyzed by SPSS v.21 software. Results: In this study, there was no statistically significant difference between sonography or mammography and pathology reports for categorizing patients in two distinct malignant and benign groups (p>0.05). There was also no difference observed in two age groups (p>0.05). In both sonography and mammography groups, the sensitivity and specificity were 60.32% and 92.96%, respectively. Moreover, the positive and negative predictive values of sonography and mammography were the same in both methods and were 70.37% and 86.56%, respectively. Conclusion: According to the significant concordance between sonographyand mammography with core needle biopsy, these non-invasive methods can be helpful in diagnosing malignant lesions and differentiating them from benign lesions; they are also affordable and available. The attention to underlying variables such as age, can improve sensitivity and specificity of non-invasive methods in comparison to invasive diagnostic methods.g.
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