BACKGROUND Pancreatitis is an inflammation of the pancreatic tissue. Gallstones are known to be the most common cause of acute pancreatitis, especially in eastern countries, including Iran. Pancreatitis, in its course, can cause complications for the patient. Different systems have been identified as predictors of the severity of acute pancreatitis. As a result, we decided to examine the factors influencing the severity of biliary pancreatitis and their relationship with the complications in Iranian society. METHODS The present study is a cross-sectional, analytical study that was performed retrospectively on 160 patients with biliary pancreatitis. The main and dependent variable in this study is the severity of pancreatitis, which is divided into two groups of complications (local complications and systemic complications) and without complications. The necessary information was extracted from the patients' files and evaluated with SPSS software version 22. RESULTS Based on the results of single-variable analysis, there was a significant relationship between the patient's age, sex, Ranson and CRP criteria, and complication of the disease. In the univariate analysis, no significant statistical relationship was found between patients' BMI(Body Mass Index), CBD (common bile duct) size, serum alkaline phosphatase level, gallstone size, and FBS(Fasting blood sugar), and the complications of the disease, based on the multivariate analysis results. CONCLUSION The results of this study showed that four variables of the female sex, stone size, CRP, and high score of Ranson criteria act as independent risk factors in the development of complicating biliary pancreatitis.

Gastrointestinal complications are common in chemotherapy patients. Although most patients’ abdominal symptoms can be due to mild chemotherapy adverse reactions, severe or life-threatening complications might occur. Typhlitis or neutropenic enterocolitis is a severe bowel wall inflammation in leukemia or solid tumor chemotherapy in neutropenic patients and may contribute to necrosis and colon perforation. Patients undergoing chemotherapy rarely experience colitis that has no standard typhlitis trait. This ischemic colitis-induced chemotherapy had conducted in patients receiving taxane-based agents. Our study presented ischemic colitis in patients receiving 5-fluorouracil, Leucovorin, and Irinotecan for sigmoid cancer that affected the transverse colon alone, unlikely for both typhlitis and chemotherapy-induced ischemic colitis. Given these findings; it is prominent to consider that life-threatening gastrointestinal complications may develop with these agents, and then surgical intervention is needed.

Background: Laparoscopic Heller myotomy (LHM) is considered the standard surgical approach in patients newly diagnosed with achalasia worldwide. However, proceeding to fundoplication after LHM remains controversial due to the observed postoperative symptoms, including dysphagia and regurgitation. This study was conducted to compare the postoperatively experienced regurgitation and dysphagia between those undergoing LHM with fundoplication and those with mere LHM. Methods: This four-year controlled clinical trial was performed on adult patients with esophageal type two achalasia, referring to the Shariati Hospital, who gave their written informed consent to enroll. The diagnosis of achalasia was confirmed using manometric assessments. The control group underwent LHM with fundoplication, while the cases received LHM without fundoplication. The validated Achalasia Patients Questionnaire was used for assessing the experienced symptoms pre- and postoperatively. Also, esophagography was used to investigate the alterations of the symptoms pre- and postoperatively. Results: A total of 48 patients were evaluated. 23 were assigned to the case group, while 25 were considered the controls (male to female ratio: 25 to 23). The mean age of the patients was 36.94 years, and the average disease duration was 6.22 years. Cases and controls were matched demographically. There was no statistically significant difference between the cases and controls regarding postoperative active or passive regurgitation or dysphagia to either solids or fluids. Also, the mean score of total clinical symptoms after the surgery was not significantly different between cases and controls. Lastly, esophagography revealed significant improvement regarding all the symptoms postoperatively (P=0.001); however, no statistically significant difference existed in this regard between cases and controls. Conclusion: Our results indicate no significant difference regarding the postoperative achalasia-related symptoms, namely regurgitation and dysphagia, between those patients undergoing LHM with and without fundoplication. However, further studies are required to thoroughly investigate the effects of various fundoplication techniques in relation to all achalasia-related symptoms to confirm these results.

Surgical site infection (SSI) is one of the most important complications of surgery and is known in quality improvement programs as a very important indicator for evaluating the performance of surgeons and hospitals. In recent studies, interesting effects for vitamin D such as antimicrobial effects, wound healing, immune regulation, etc. have been considered and the effectiveness of this vitamin on the above has been proven in laboratory environments and animal models. Therefore, the present study was designed and performed to evaluate the effect of vitamin D tablets before surgery on surgical site infection in patients referred to Shariati Hospital. This study was performed as a randomized controlled trial (RCT) on 200 patients who underwent surgery in Shariati Hospital in Tehran and in the general surgery department between 1397 and 1398. Patients were randomly assigned to two groups of 100 persons, including intervention and control. In all patients, vitamin D levels were measured and recorded 15 days before surgery. The intervention group included patients who received 2 tablets of fifty thousand units of vitamin D seven to ten days before the operation. The second group also included patients who did not undergo any intervention and only in order to maintain blindness of the same size and simultaneously with the first group. They received a placebo. Finally, all patients were followed at intervals of one, three, seven and thirty days after surgery and then compared to the extent of infection at the site of surgery and other desired variables. In this study, 200 persons with a mean age of 47.78 years were examined. 57.5% (115 persons) were female and the rest were male. Overall, 19 (9.5%) of the patients studied underwent surgery at the site of follow-up within one month of follow-up (14 in the control group and 5 in the intervention group). Detection between the two groups was observed in terms of infection (P=0.030). In general, based on the results of the analysis, in the present study, there was a statistically significant relationship between surgical site infection with low serum vitamin D level, increase in the number of hospital days, female gender, wound classification, ASA class of patients and vitamin D consumption before surgery. (P<0.05). The results of this study showed that there is a significant relationship between surgical site infection and consumption of edible vitamin D as well as serum vitamin D levels before surgery so that vitamin D deficiency can be considered as an independent risk factor for infection. Hospitals were considered, including surgical site infections. Therefore, performing preoperative tests as well as performing the required interventions can be very effective in improving this index and reducing surgical site infections.