Tehran University of Medical Sciences (TUMS) Academic Journal of Surgery 2423-3218 9 1 2026 10 25 1 5 Sepideh Aarabi 1 Department of Emergency Medicine, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran 2 Research Development Center, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran 2026 08 21 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. https://ajs.tums.ac.ir/index.php/ajs/article/view/351

Tehran University of Medical Sciences (TUMS) Academic Journal of Surgery 2423-3218 9 1 2026 10 25 6 11 Hannan Ebrahimi Department of Neurosurgery, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran. Mohammad Javad Ebrahimi Department of Neurosurgery, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran Amir Kian Moaveni Department of Neurosurgery, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran Maral Moafi Department of Neurosurgery, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran Ahmad Pour-Rashidi 1. Department of Neurosurgery, Sina Hospital, Tehran University of Medical Sciences (TUMS), Tehran, Iran Azar Hadadi Department of Infectious Disease, Sina hospital, Tehran University of Medical Sciences (TUMS), Tehran, Iran Mahnaz Montazeri Department of Infectious Disease, Sina hospital, Tehran University of Medical Sciences (TUMS), Tehran, Iran Marziyeh Pakozi Department of Pulmonary Disease, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran Samira Kafan Department of Pulmonary Disease, Sina hospital, Tehran University of Medical Sciences (TUMS), Tehran, Iran Shahin Nasseri Department of Neurosurgery, Sina Hospital, Tehran University of Medical Sciences (TUMS), Tehran, Iran Zeinab Gholami Department of Neurosurgery, Sina Hospital, Tehran University of Medical Sciences (TUMS), Tehran, Iran Maryam Aghayerashti Faculty of Mathematical Science, Shahid Beheshti University, Tehran, Iran Gilda Kianimehr Department of Psychiatry, Sina hospital, Tehran University of Medical Sciences (TUMS), Tehran, Iran Abbas Amirjamshidi Department of Neurosurgery, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran 2025 11 06 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. https://ajs.tums.ac.ir/index.php/ajs/article/view/332

Tehran University of Medical Sciences (TUMS) Academic Journal of Surgery 2423-3218 9 1 2026 10 25 12 18 abhishek sharma Faculty Medical and Administrative Head, Medical Superintendent, Director of Plastic Surgery Services, Department of Plastic Surgery, ALL IS WELL Multispecialty Hospital, Burhanpur, Madhya Pradesh, India 2026 04 09 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. https://ajs.tums.ac.ir/index.php/ajs/article/view/343

Tehran University of Medical Sciences (TUMS) Academic Journal of Surgery 2423-3218 9 1 2026 10 25 19 33 Alieh Zamani Kiasari Department of Anesthesiology, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran. Aida Ghorbanzadeh Department of Anesthesiology, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran. Samira Sobhani Student Research Committee, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran. 2026 05 09 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. https://ajs.tums.ac.ir/index.php/ajs/article/view/344

Tehran University of Medical Sciences (TUMS) Academic Journal of Surgery 2423-3218 9 1 2026 10 25 50 56 ali dahmardeh shariati hospital Shirzad Nasiri Endocrine Surgery Division, Department of Surgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran Sam Moslemi Endocrine Surgery Division, Department of Surgery, Army Family Hospital, AJA University of Medical Sciences, Tehran, Iran Sina Sharghi Endocrine Surgery Division, Department of Surgery, Emam Ali Hospital, Alborz University of Medical Sciences, Karaj, Iran Aidin Yaghoobi Notash Colorectal Surgery Division, Department of Surgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran 2026 06 29 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. https://ajs.tums.ac.ir/index.php/ajs/article/view/347

Tehran University of Medical Sciences (TUMS) Academic Journal of Surgery 2423-3218 9 1 2026 10 25 34 49 Fatemeh Shokri Emami Department of Anesthesiology, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran. Alieh Zamani Kiasari Student Research Committee, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran Samira Sobhani Student Research Committee, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran 2026 05 09 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. https://ajs.tums.ac.ir/index.php/ajs/article/view/345