Academic Journal of Surgery

The COVID-19 Related Cognitive Impairments Among Non- Hospitalized and Hospitalized Patients; A Comparative Study

Hannan Ebrahimi — 2026-10-25

Background: Different patterns and severity of neuropsychological symptoms are reported in patients with
COVID-19. The exact pathophysiologic mechanisms responsible for the neuropsychological manifestations of
COVID-19 remain unknown. This study aimed to compare the cognitive impairments between hospitalized and
non-hospitalized patients with COVID-19.
Methods: This cross-sectional study was performed in a referral hospital in Iran from March 2020 to March 2021. Neuropsychiatric assessments were conducted using the Addenbrooke’s Cognitive Examination (ACE) test. Demographic factors, medical history, hospitalization duration, and ACE scores were assessed. Statistical analysis was performed using SPSS.
Results: In this study, 219 patients with COVID-19 (114 hospitalized and 105 non-hospitalized) were evaluated.
The mean age of hospitalized patients was significantly higher than that of outpatient participants (48.46 vs.
34.32 years; P < 0.001). Gender, handedness, education level, and habitual history did not differ significantly
between the two groups. Dexamethasone administration was significantly more common in hospitalized patients.
The total and subgroup ACE scores in hospitalized patients were significantly lower than those in the outpatient
group. Cognitive impairments were detected significantly more frequently in hospitalized patients. Multivariate
analysis showed that cognitive impairments were significantly more common among hospitalized patients (P <
0.001).
Conclusions: The cognitive ability of hospitalized patients with COVID-19 is lower than that of their outpatient
counterparts regarding executive function, verbal fluency, memory, language, and visual perception. Hospitalized patients with COVID-19 should undergo more detailed neuropsychological evaluations and receive appropriate treatments accordingly.

Effect of Oral Betahistine in Reducing Postoperative Nausea and Vomiting Following Hysteroscopic Surgery under General Anesthesia

Alieh Zamani Kiasari — 2026-10-25

Background: Postoperative nausea and vomiting (PONV) is a common and distressing complication after gynecological surgeries, particularly hysteroscopy. This study aimed to determine the effect of oral betahistine
on reducing the incidence and severity of PONV after hysteroscopic surgery under general anesthesia.
Methods: This double-blind, randomized clinical trial was conducted on 94 candidates for hysteroscopic surgery
at Imam Sari Educational Medical Center in 2024. Patients were randomly assigned to two equal groups (n = 47
each). The intervention group received oral betahistine (16 mg three hours and 8 mg two hours before surgery),
and the control group received placebo. The incidence and severity of PONV, pain intensity, morphine and ondansetron consumption, and adverse effects were evaluated at 2, 4, 6, 12, 24, and 48 hours postoperatively.
Results: The incidence of PONV was significantly lower in the betahistine group than in the placebo group at
all time points (32% vs. 68% over the entire period, p < 0.001). The mean nausea severity was also significantly
lower in the betahistine group (2.3 ± 1.4 vs. 4.8 ± 2.1, p < 0.001). Morphine and ondansetron consumption during
the 48-hour postoperative period were significantly lower in the betahistine group (p < 0.001). No significant
difference in adverse effects was observed between the two groups. Older age, higher BMI, and longer anesthesia duration were identified as independent risk factors for PONV.
Conclusions: Prophylactic oral betahistine administration before hysteroscopic surgery under general anesthesia appears to be an effective, safe, and cost-effective strategy to reduce the incidence and severity of PONV, decrease the need for rescue antiemetics, and improve the quality of postoperative recovery.

The Effect of Preoperative Injectable Dexamethasone on Postoperative Pain Following Hysterectomy in Patients Hospitalized at Imam Hospital of Sari in 2024-2025

Fatemeh Shokri Emami — 2026-10-25

Hysterectomy is one of the most common gynecological surgeries, recognized as the most frequently performed
gynecological surgical procedure worldwide (1, 2). The main reasons for performing this surgery include uterine
fibroids, abnormal uterine bleeding, and pelvic pain (2, 3). In Germany, 17.5% of women aged 18 to 79 have
experienced this surgery, with most cases occurring in the 40 to 49 age group (4). The prevalence of hysterectomy
in different countries is influenced by socio-economic factors and access to healthcare services (5). In Iran, the
number of hysterectomy operations in a university clinic in Tehran averaged 219 cases per year between 2005
and 2009, and most women were in the 45 to 54 age group.

A Contemporary Review of Hydrogel Dressings for Wound Care

abhishek sharma — 2026-10-25

Chronic wounds are considered a burden for healthcare and do not progress through the wound healing process in a timely manner. They are also the most common reason for a decrease in quality of life in patients. Hydrogel dressings have become essential in the realm of wound management and care. Traditional wound dressings, e.g., gauzes and bandages, require regular application and are effective for dry to mild, exudating wounds, although they are highly absorbent, which therefore can cause pain upon dressing change. In addition, they cannot provide enough drainage and have poor adhesion properties for wounds. Modern dressings such as hydrogels, are aimed at solving these issues. They create a moist environment that not only encourages tissue healing but also works well with a variety of wound types. At the same time, unlike other types of modern dressings (foam, films, and hydrocolloids), hydrogels have positive degradation properties, which makes them the perfect choice for targeted delivery of bioactive substances to the wound if needed. Hydrogel dressings hold considerable promise in the field of wound management. Continuous research is crucial to address challenges, resolve current controversies, and improve the efficacy and sustainability of these dressings for superior wound care. This mini review is focused on the advantages of hydrogels over different types of traditional and modern wound dressings.

Silent Threat in the Abdomen: A Pancreaticoduodenal Artery Aneurysm Unmasked by Recurrent Epigastric Pain

Sepideh Aarabi — 2026-10-25

Pancreaticoduodenal artery aneurysms are rare visceral arterial aneurysms with a high risk of rupture, which is
not necessarily related to aneurysm size. We report a 32-year-old woman with recurrent epigastric pain who was
found to have a 20-mm inferior pancreaticoduodenal artery aneurysm associated with significant celiac artery
stenosis and extensive collateral circulation through the pancreaticoduodenal arcade. Because embolization
alone could compromise hepatic perfusion, an aorto-hepatic bypass was performed followed by staged coil
embolization of the aneurysm two weeks later. Complete aneurysm exclusion and graft patency were confirmed
at six-month follow-up, and the patient remained asymptomatic. This case highlights the importance of assessing
celiac artery patency and collateral circulation when managing pancreaticoduodenal artery aneurysms. CTA is
essential for diagnosis and treatment planning, and staged revascularization followed by aneurysm exclusion
may be a safe option in patients with significant celiac artery disease.

Giant Parathyroid Adenoma Excised through Endoscopic Trans- Axillary Parathyroidectomy; A Case Report with Literature Review

ali dahmardeh — 2026-10-25

Large parathyroid adenomas consist 1.5% of all adenomas. While minimally invasive parathyroidectomy is the method of choice with established advantages, surgeons prefer open surgery for large adenomas to reduce surgical risks. Here, we present a 41-year-old male with primary hyperparathyroidism due to large size parathyroid adenoma (3.2 cm) that was removed successfully by endoscopic trans-axillary parathyroidectomy. This presentation can guide surgeons to choose this minimally invasive technique, even for large adenomas.