Comparison of early results and complications between multi-and single-port sleeve gastrectomy: a randomized clinical study

Background: In recent years, laparoscopic sleeve gastrectomy [LSG] has become more acceptable for obese patients. Single-port sleeve gastrectomy [SPSG] is more popular since each abdominal incision carries the risk of bleeding, hernia, and internal organ injury as well as exponentially affecting cosmesis. This cross-sectional study aimed at comparing multi-port sleeve gastrectomy [MPSG] and SPSG in terms of their early results and complications

Methods: Out of129 obese patients candidated for LSG, 102 patients were assigned to 2 groups of SPSG and MPSG. Complications and demographic data such as body mass index [BMI], age, gender, operation time, and hospital stay were measured. All surgeries were carried out between2013 and 2015 in Shiraz, Iran. Data analysis was performed using SPSS, version 16 for Windows [SPSS Inc., Chicago, IL]. The continuous and categorical variables were compared using the Student t-test and the Chi-square test or the Fisher exact test, respectively

Results: The patients' data from both groups were similar in terms of age, intraoperative and postoperative bleeding volume, and length of hospital stay. Mean BMI was 42.8+/-0.7 in the SPSG group and 45.3+/-1.2 in the MPSG group. Duration of surgery was significantly lower in the SPSG group [P<0.001]. Only 1 patient from the SPSG group and 5 patients from the MPSG group had bleeding as an early complication

Conclusion: The differences in each complication between the groups were not statistically significant. SPSG seems to be safe and is the same as MPSG in terms of major postoperative complications

[ evidence-based guideline for school-based interventions to prevent smoking]

Background and Aim: Smoking is one of the most important current problems in the world. It has important adverse effects on children and young people. The majority of people start smoking before the age of 18. School-based interventions can play an essential role in the prevention of smoking. The aim of this study was to provide a national evidence based guideline for school- based interventions for prevention of smoking

Material and Method: We conducted a comprehensive search to find related clinical practice guidelines in recent five years using related databases and websites. Related guidelines were selected and appraised by two independent experts using the Appraisal of Guidelines Research and Evaluation-2 AGREE-2 tool. The selected guidelines were translated into Persian, evaluated and confirmed by the panel of experts

Results: Among 11 guidelines, one with five main recommendations for school based interventions was selected. Each recommendation contained three sections that helped to provide an action plan to prevent smoking, including:"Target population", "People who should take action" and "Actions they should take"

Conclusion: School based interventions had been effective for prevention and control of smoking in adolescence. This guideline is evidence based and a well adopted tool. Therefore, it can be a useful guideline for school-based intervention planning

inverse association between mediterranean-like dietary pattern and blood pressure in male, but not female, adults in Shiraz

Background: Dietary pattern is an effective way of studying the effect of diet on diseases. We investigated the association between dietary patterns and blood pressure [BP] in adults aged 20-50 years

Methods: In a cross-sectional design, 418 individuals were selected through stratified multistage random sampling from households living in different regions of Shiraz. Information on demographic characteristics, anthropometric features, dietary intakes, and systolic [SBP] and diastolic [DBP] blood pressure was gathered. Dietary patterns were determined using a validated food frequency questionnaire

Results: Three dietary patterns were specified: vegetable [high in vegetables and legumes], Western-like [high in meat, sugar sweetened beverages, salty and sweet snacks, refined grains, high-fat dairy], and Mediterranean-like [rich in low-fat dairy, fruit, vegetables, nuts, olive, fish, and low in hydrogenated fats]. After adjustment for confounders, Mediterranean-like dietary pattern had an inverse association with SBP [beta =-0.24; 95% CI: -5.25, -1.27] and DBP [beta =-0.17; 95% CI: -3.65, -0.20] in males but not females. Vegetable and Western-like dietary patterns were not associated with BP in either sex after adjusting for confounders. Positive relationships were observed between BP and body mass index [r=0.28 and 0.33 for SBP and DBP, P<0.001], waist circumference [r=0.51 and 0.45 for SBP and DBP, P<0.001], and waist-to-hip ratio [r=0.54 and 0.44 for SBP and DBP, P<0.001]. Dietary energy and carbohydrates were positively and fats inversely associated with BP. Among micronutrients, vitamin E had a significant inverse association with BP

Conclusion: Mediterranean-like dietary pattern may lower the risk of hypertension in Shiraz males

Preparation and characterization of celecoxib dispersions in soluplus[R]: comparison of spray drying and conventional methods

The present study deals with characterization of dispersions of a poorly water-soluble drug, celecoxib [CLX] in polyvinyl caprolactame-polyvinyl acetate-polyethylene glycol graft copolymer [Soluplus[R] [SOL]] prepared by different techniques. Dispersions of CLX in SOL at different ratios [2:1, 1:1, 1:2, 1:4 and 1:6] were prepared by spray drying, conventional solvent evaporation and melting methods. The solid states of samples were characterized using particle size measurements, optical and scanning electron microscopy, XRPD, DSC and FT-IR. The Gordon-Taylor equation was used to predict the T[g] of samples and the possibility of interaction between CLX and SOL. The solubility and dissolution rate of all samples were determined. Stability of samples was studied at ambient conditions for a period of 12 months. DSC and XRPD analyses confirmed amorphous state of drug in samples. Surprisingly dispersions of CLX:SOL with the ratio of 2:1 and 1:1 showed slower dissolution rate than CLX while other samples showed higher dissolution rate. At 1:2 ratio the spray dried samples exhibited higher dissolution rate than corresponding samples prepared by other methods. However at higher SOL content [1:4 and 1:6], samples prepared by different methods showed similar dissolution profiles. The stability studies showed that there were no remarkable changes in the dissolution profiles and solid state of the drug after 12 months storage at ambient conditions. It was concluded that SOL was a proper carrier to enhance the dissolution rate of CLX. At high SOL ratios the method of preparation of dispersed samples had no effect on dissolution rate, whilst at low SOL content spray drying was more efficient method

effects of prioritize inspections on occupational health hazards control in workplaces in Iran

Iran, a newly industrializing country in Middle East, has a workforce of 25 million people. Most employees are working in agriculture, manufacturing, services, construction, commerce sectors, carpet weaving and mining. This article aims to explore the improvement of occupational harmful agents in workplaces due to implement "prioritize inspections". In 2012, the system of "prioritize inspections "was defined for surveillance on enterprises replace of routine inspection. From this system, the enterprises classified on four groups based on health hazards and enterprises with high risk were under more surveillance. The information about each enterprise was collected by health centers, in five provinces and reported by a recommended form to Centre of Environmental and Occupational Health [CEOH]. At this program, the inspections from high and medium hazards were increased in all of provinces. The results showed there was a significant difference between the control of health hazards in before and after beginning of "prioritize inspections"[P=0.048]. The control of noise, fumes and providing of proper illumination increased from 8 to 10%, 9to 9.5%, 12.9 to 15.4%, respectively, at under study provinces in 2012 compared to 2011. The surveillance based on "prioritize inspections" increased the quality of occupational health inspections that causes to prevent occupational health diseases

Effect of roasting process on total phenolic compounds and gamma-tocopherol contents of Iranian sesame seeds [sesamum indicum]

Sesame [Sesamum indicum L.] seed and oil have long been used widely as healthy foods to supply energy and prevent aging. Some of the main active anti-oxidative constituents in sesame seeds are y-tocopherol and phenols. The purpose of this study was to investigate the relationship between roasting temperature and time with gamma -tocopherol and total phenolic compounds [TPC] of sesame seeds when roasted in a domestic electric oven. Eight cultivars of sesame seeds in this study were Darab, Dezful, Karqj, Moghan, Naz-Branching, Naz-NonBranching, Siah and Varamin. Each cultivar was divided into ten group based on the roasting time [10, 15 and 20 min] and temperatures [180, 200 and 220 °C] andunroasted one. The high-performance liquid chromatography [HPLC] and spectrophotometeric methods were used for gamma-tocopherol [n = 80] and TPC [n = 80] analysis, respectively. The gamma -tocopherol content ranged from 329 +/- 5 mg/L in Naz-Branching sesame oil to 1114 +/- 7 mg/L in Siah sesame oil and 169 +/- 6 to 577 +/- 1 mg/kg in sesame seed respectively, gamma -tocopherol content of six cultivars increased significantly [p < 0.05] as the roasting temperature and time; until 200 °C for 10 min, but they were decreased by roasting at 220 °C in longer time. Also TPC increased significantly as the roasting temperature. The amount of TPC varied in different sesame cultivars from 20.109 +/- 3.967 microM to 129.300 +/- 3.493 in Varamin and Naz-Branching sesame seed cultivars, respectively, also TPC increased from 70.953 +/- 5.863 microM in unroasted Naz-Branching sesame seed to 129.300 +/- 3.493 microM after roasting in 200 °C for 20 min. The present study showed that Iranian sesame seed can be considered as a good source of natural antioxidant specially after roasting. The optimum temperature and time roasting to obtain the most y-tocopherol and total phenolic content was 200 °C for 10 and 20 min, respectively

Femtosecond laser versus mechanical microkeratome in thin-flap laser in situ keratomileusis [Lasik] for correction of refractive errors an evidence-based effectiveness and cost analysis

To compare the efficacy and cost-effectiveness of Femtosecond laser versus mechanical Microkeratome corneal flap creation in correction of refractive errors. In this review, a comprehensive search of Medline, SCOPUS, Cochrane, TRIP database, supplemented by HTA and economic databases was performed. We searched for randomized controlled trials [RCTs] of Femtosecond laser which included mechanical Microkeratome in other arm. The quality of the retrieved studies was appraised by two independent reviewers and appropriate articles were finalized. A total of 1142 articles were identified, of which, 1059 were excluded after review of the titles and abstracts and 83 articles remained. Systematic reviews and RCTs were evaluated through CASP international worksheet. Eventually, 61 titles were excluded, leaving 22 articles to be reviewed. Safety: There was no individual evidence to cover all safety components about Femtosecond laser, but in summary, this modality seems a safe method for corneal flap creation. Effectiveness: No statistically significant difference was shown in visual acuity and refractive errors. The important secondary end point of this review was diffuse Lamellar keratitis in 17% of the Femtosecond group versus 5% in mechanical Microkeratome. Inflammation was low-grade and improved during the first 3 months of follow-up period with a low dose medication without corneal scarring. The two groups was comparable in all clinical outcomes including Unorrected Visual Acuity [UCVA], Best Special Corrected Visual Acuity [BSCVA], manifest refraction, wave front aberrometry, Schirmer test, and Tear Break up time [TBUT]. Cost Analysis: Results showed that marginal cost incurred due to Femtosecond technology adoption may vary from 27 to 117 _ [resulted from sensitivity analysis]. It is clear that additional cost may be a small proportion of LASIK procedure total cost. Although Femtosecond flap creation is a modern method with a good quality of corneal flap, but, there is no high-quality evidence to show superiority of Femtosecond laser in clinical outcomes. Although the efficacy and cost of the systems is almost equal, traditional method still remains as the standard approach

Holmium laser prostate enucleation [HOLEP] versus trans-urethral resection of prostate [TURP] in treatment of symptomatic prostatic enlargement; a health technology assessment

Our aim was to compare the cost effectiveness of holmium laser prostate enucleation [HOLEP] versus trans-urethral resection of prostate. We searched all available databases for any controlled trials comparing HOLEP and TURP from January 2000 to February 2009. Two independent reviewers studied and appraised the selected evidences. Then, effectiveness and cost effectiveness of HOLEP was evaluated. We identified four randomized controlled trials and one systematic review according to the inclusion criteria. Most of the studies had moderate quality of evidence with limited sample sizes. Overall success rate of HOLEP was comparable with TURP; but, some secondary outcomes such as pick flow rate twelve months after the surgery was better in HOLEP. A comparison between the original costs and those obtained from sensitivity analysis showed that the cost parameters were sensitive to the number of the patients treated. Increasing the number of the patients from 200 to 300 changed the study's results in favor of the new techniques. Since the holmium and thulium laser sets are sensitive to the number of the patients and multipurpose, they potentially can be applied for stone fragmentation. Thus, utilization of these equipments will divide the costs between two groups of the services. In economic terms, these properties lower overhead costs and justify the purchasing of these equipments

Comparison of ethylcelluose matrix characteristics prepared by solid dispersion technique or physical mixing

The characteristics of ethylcellulose matrices prepared from solid dispersion systems were compared with those prepared from physical mixture of drug and polymer. Sodium diclofenac was used as a model drug and the effect of the drug:polymer ratio and the method of matrix production on tablet crushing strength, friability, drug release profile and drug release mechanism were evaluated. The results showed that increasing the polymer content in matrices increased the crushing strengths of tablets. However the friability of tablets was independent of polymer content. Drug release rate was greatly affected by the amount of polymer in the matrices and considerable decrease in release rate was observed by increasing the polymer content. It was also found that the type of mixture used for matrix production had great influence on the tablet crushing strength and drug release rate. Matrices prepared from physical mixtures of drug and polymer was harder than those prepared from solid dispersion systems, but their release rates were considerably faster. This phenomenon was attributed to the encapsulation of drug particles by polymer in matrices prepared from solid dispersion system which caused a great delay in diffusion of the drug through polymer and made diffusion as a rate retarding process in drug release mechanism