[ survey on inhalation effect of essence of peppermint on nausea and vomiting after abdominal surgery in patients who have been admitted to Besaat and Tohid hospitals in Sanandaj]

Nausea and vomiting is among the most common complications in patients recovering from general anaesthesia, 30-70 of patients experience nausea and vomiting after surgery. Although variety of medications have been used to control this complication, it still remains as a problem. Armothpy a non pharmacologic intervention is suggested for treatment of many conditions and Pepprmint may be effectivein treatment of common digestive conditions. This aim of this study was to examine the efficacy of inhaling peppermint essence for prevention of nausea and vomiting after abdominal surgery in patients admitted in Beasssat and Tohid hospitals in Sanandaj in 2011. A randomized clinical trial was conducted to examine the efficacy of Peppermint essence inhalation for prevention of post- surgical nausea and vomiting. The sample of the study consisted of 90 patients, which were randomly allocated to receive peppermint inhalation or saline normal. A 2 x 2 gauze pad saturated with two drops of pure pharmacy-grade peppermint essence was used for 1 minute in intervention group. For patients in control group a 2 x 2 gauze pad saturated with 0. 9% normal saline was used. A visual analog scale was used to rate nausea. Patients were followed in recovery and surgical ward for occurrence of nausea and vomiting. Data were analyzed by SPSS software, version 17. There was not statistical difference between two groups in terms of confounding variables such as body mass index, length of anesthesia as well as type of anesthesia. 6. 7% of patients in peppermint group and 0% of patients in control group experienced mild nausea. Manwitney statistical test, showed no significant difference between the two groups in terms of nausea in recovery room. The results indicated there was significant difference between the two groups in the severity of nausea in surgical ward. There was not a significant difference between two groups in term of numbers of vomiting. The findings of the study showed no diferrence between peppermint and saline in terms of prevetion of nausea and vomiting. One reason can either be ineffective breathing patterns of patients after anesthesia or insufficient dose of peppermint which has affected the results of this study. It seems more studies with various shapes and amounts of peppermint are required in this regard

[Obesity in type 2 diabetes: a review of health economics evidences]

Introduction: Type 2 diabetes mellitus, a serious chronic disease, is increasing worldwide. Obesity is one of the main independent risk factors in development of the diabetes and its related complications. Weight loss is an important part of disease management

Methods: We searched for the studies conducted on obesity treatment of patients with diabetes until the end of September 2010 in the SID and Pub Med databases. We used the economic evaluation methods in order to evaluate the cost of obesity in patients with type 2 diabetes and its treatment methods. We also analyzed the costs and outcome implications of obesity and its management in people with type 2 diabetes

Results: Studies have shown that obesity treatment with Orlistat is cost effectiveness. In Germany and France, surgery is a dominant option in comparison with the other common methods. In England, surgery is reported to be cost effective and in Austria, Italy and Spain, it is approved

Conclusion: All studies have reported that obesity treatments are in the range of what is generally considered as cost-effective. It seems that medication therapy and surgery are cost-effective options for all obese patients

[Fluoride uptake level of the enamel by a fluoride varnish and a fluoride gel [APF]]

Statement of Problem: Various forms of fluoride-contained products are used to increase the resistance of the tooth against caries for preventive purposes. Furthermore, studies demonstrated higher fluoride uptake with varnish and gel among the wide range of products

Purpose: This study compared fluoride uptake of Duraflor[registered sign] varnish [Practicon Dent, USA] with fluoride gel [APF, Sultan[registered sign]], used on the enamel surface of the intact teeth

Materials and Method: In this experimental in-vitro study, 20 intact pre-molar teeth extracted for orthodontic purposes were randomly assigned to two groups of 10 teeth. The teeth were sectioned into two mesial and distal halves as the control and experimental sides. Defined semi-circular areas on the enamel surface of the experimental halves were treated with gel or varnish for 1 hour. The sample halves were stored in artificial saliva for 24 hours at 37[degree sign]c, etched for 30 seconds by 0.5 M perchloric acid, and washed by 0.2 m KOH after each etching process. Biopsies of the samples were obtained by Acid Etch Enamel Biopsy technique and the fluoride and calcium concentrations were calculated by potentiometer and spectrophotometer, respectively. Kolmogorov-smirnov, Paired t-test and Student t- test were used for statistical analyses

Results: The results demonstrated an increase in the enamel fluoride content after exposure of the teeth to both Duraflor[registered sign] varnish and APF gel [Sultan[registered sign]]. The results of the paired t-test revealed significant differences between the experimental and control halves in both groups [varnish: p =0.002, gel: p =0.039]. The fluoride uptake value in varnish and gel groups was 2069.78 ppm and 1050.99 ppm, respectively. The student t-test showed a statistically significant difference [p =0.01]

Conclusion: Both APF gel and Duraflor[registered sign] varnish increased the fluoride content of the tooth enamel after application, although Duraflor[registered sign] varnish had a higher fluoride uptake level than APF gel

[ productivity of general hospitals of Ardebil Province [1999-2006]]

The Main reason for using productivity and efficiency analysis in all areas of management, in particular hospitals, is the resources constraint. The aim of this study was to measure the productivity in general hospitals of Ardebil province. This was a descriptive analytical retrospective study, carried out in 10 general hospitals within the Province of Ardebil in 2008. The Data Envelopment Analysis [DEA] technique and the Malmquist Total Factor Productivity Index were employed to measure the productivity and variables such as the number of GPs, number of active beds, number of admissions, and the days of hospitalizations were taken into account. Collection of data within the last 7 years was accomplished using the Standard Forms designed by the Ministry of Health and Medical Education's Statistical Department. Data analysis was performed using the Deap2 software. Based on our data, the Total Factor Productivity mean was 1.033 indicating a decrease of 3.3% in productivity within this period. The technical efficiency change and also the technological change as component of productivity were 1.044 and 1.029, respectively. The trend of productivity over the study period failed to follow any particular trend. In the first three years, the productivity was reduced while within the next two years it was increased. Nevertheless, the productivity again faced a decrease within the next year. The total factors productivity during the study period showed a decreased productivity. The productivity losses were largely due to technological changes. Numerous studies carried out in other countries, particularly in low income countries, produced similar results in which the major cause of lower productivity was attributed to technological changes

Anaplastic thyroid carcinoma, a report on 10 cases

Anaplastic thyroid carcinomas are undifferentiated and highly aggressive tumors of the thyroid follicular epithelium, with a disease-specific mortality approaching 100 percent. This study reports ten cases with advanced anaplastic thyroid carcinoma with ineffective surgical interventions. Between 2001-2006, we treated 10 patients with anaplastic carcinoma of the thyroid. All patients presented with advanced phase and were documented by pathological study. The surgical intervention was thyroidectomy in 3 cases, debunking surgery in other three, just tracheostomy in three cases, and only biopsy in one patient. All of our patients died in 4 days to 8 months after surgery. Surgical intervention had no benefit in treatment of advanced anaplastic carcinoma of the thyroid and the suitable surgical intervention was to maintain an open airway. Early recognition of the disease is essential to allow prompt initiation of therapy. There is no cure for advanced situations, and surgery, radiotherapy, and chemotherapy play no important role in the treatment

[Relationship of HER-2 with other clinical- pathological diagnostic criteria in breast cancer patients]

Introduction: HER-2/neu is a membrane protein and it is one of the determining prognostic factors of breast cancer

Objective: The aim of the study was to investigate the relationship between the expression of the HER-2 membrane protein and clinical- pathological parameters such as size: degree of the tumor differentiation, presence or absence of lymphovascular invasion and its relation with steroid hormone and P53 status in breast cancer patients

Materials and Methods: This descriptive study was done on 465 cases of breast cancers referred to two cancer centers in Gilan from 1980-1985. Patients' demographic data, pathological and type of clinical therapy were gathered from their medical charts. All membrane samples taken by biopsy were embedded in paraffin and stained by hematoxylin-eosin technique and were evaluation by a semi-quantitative method of immunohisto- chemistery for HER2 protein, P53 and steroidal receptor

Results: A total of 32% of breast cancer patients had positive HER2 protein. There was a positive correlation between HER2 protein and P53 protein expression [P=0.000]. There was a positive relationship between presence of HER2 protein and absence of steroid receptor with high-grade tumor [grade 3][P=0.3] and absence of HER2 and presence of steroid receptor with low-grade tumor [grade 1] [P=0.5]. There was no correlation between HER2 and lymphovascular invasion and size of tumor

Conclusion: In breast cancer patients, there is a positive correlation between presence of HER2 protein and degree of tumor differentiation and it also correlates with poor prognostic factors such as hormone receptor negativity and P53 positivity

[Correlation of P53 protein expression with clinicopathologic parameters and hormonal receptor status in breast cancer patients]

Introduction: Mutation of the P53 gene is thought to stimulate cell growth and to be involved in the development and progression of tumors

Objective: The aim of this study was to survey the relationship of P53 with other clinic pathological parameters such as size of tumor, grade of malignancy, lymph vascular attacks, and also its correlation with the condition of steroid receptors in breast cancer patients [BCP]

Materials and Methods: The study samples were chosen from 465 BCPs who had breast surgery or excistonal biopsy. Immunohistochemistery method was applied for the detection of estrogen and progesterone receptor and HER2 and P53. According to hormone receptor status, cases were either hormone receptor positive [ER+ or PR+] or hormone receptor negative [ER- and PR-]. We divided patients into two groups: low grade instead of grade1, and high grade instead of grade 2 and 3

Results: 29.7% of our 465 cases were P53 positive. The mean age of P53negative cases was significantly more than P53 positive ones. [49.2 y/o vs. 46.7 y/o] P53 protein Expression correlated positively with HER2 protein expression. [P=0.000]. P53 negativity and hormone receptor positivity had a positive correlation with low-grade tumor [P=0.007]. There were no significant correlation between P53 and lymphovascular invasion and relapse and tumor size

Conclusion: Our results show that tumors of low malignant potential [grade1] have an immunophenotype of P53-, ER+, PR+, while high grade tumors [grade3] frequently express a P53+ and ER-, PR- phenotype. Negativity of P53 has a significant correlation with good prognostic factors like hormone receptor positive and low gradity, so evaluation of biologic marker of P53 is helpful to select the protocol of treatment in patients with equal stages