Pre-operative rectal indomethacin for reduction of postoperative nausea and vomiting after laparoscopic cholecystectomy: a double-blind randomized clinical trial

To evaluate the effect of pre-operative indomethacin suppository on postoperative nausea and vomiting in patients undergoing laparoscopic cholecystectomy. A double blind placebo-controlled randomized clinical trial. Hazrat Rasoul Akram Hospital, Tehran, Iran, from February 2010 to September 2012. One hundred and thirty patients, scheduled for laparoscopic cholecystectomy, were randomly divided into case and control groups. Sixty-five patients received indomethacin suppository and 70 patients received rectal placebo in the case and control groups respectively. All patients underwent the same protocol in laparoscopic surgery and anesthesia, then nausea and vomiting was recorded after 1, 6, 12 and 24 hours postoperatively and compared between the two groups. Independent-sample t test or Mann-Whitney tests were used for statistical analysis. Level of statistical significance was set at P

[Effect of preoperative education on recovery time of laparoscopic cholecystectomy: a randomized clinical trial]

Background: Nowadays, new methods are emerging each month for a better operation with fewer complications. Laparoscopic surgery have remarkable advantages, Compared to open, such as smaller incision, less manipulation of the digestive system, less postoperative pain, fewer wound complication and faster discharge from the hospital

Therefore it is preferred by patients and surgeons and is replacing the traditional open surgical methods. However, any operation causes significant panic for patients and lack of knowledge about the surgical method is found to cause poor surgical outcomes, such as recovery time after the surgery we evaluated the effect of preoperative education on the recovery time of laparoscopic cholecystectomy candidates

Methods'. This randomized clinical control trial was performed at Imam Khomeini and Alborz Hospitals in Karaj from February 2010 till January 2011. Using randomized sampling method, 100 female candidates for laparoscopic cholecystectomy were divided into two equal groups of case and control

The case group received detailed information about operating room's condition, surgical equipment, anesthesia method, advantages and disadvantages of laparoscopic procedures, and patient's role in self-care at recovery, whilst the control group received no education before the surgery. The two groups were compared regarding recovery time based on Aldrete modified checklist and mean time to reach the Aldrete consciousness score of 9 and the incidence of nausea was assessed among them

Results: The analysis showed that there was a significant difference between the mean time to reach Aldrete consciousness modified checklist score of 9 between the case and control group [18.04+/-3.87 vs. 29.66+/-5.44, respectively, P<0.001], therefore the case group had shorter recovery time than the control group. 10 of the case group [20%] and 3 of the control group [6%] had nausea after recovery [P=0.037, OR=0.255 [CI 95%: 0.066-0.992]]

Conclusion: Preoperative education of patients can significantly decrease the recovery time after laparoscopic cholecystectomy surgery

Therefore, it is strongly recommended to include the preoperative education in routine care of laparoscopic cholecystectomy patients for better surgical outcomes

Assessment of C-reactive protein and C3 as inflammatory markers of insulin resistance in women with polycystic ovary syndrome: a case-control study

Polycystic ovary syndrome [PCOS], a common endocrine disorder, is associated with infertility, menstrual dysfunction, hirsutism and frequent miscarriages. Insulin resistance, as a major cause of PCOS, represents a disorder with increase in inflammatory markers and risk of type 2 diabetes. We aimed to investigate whether inflammatory markers, including C-reactive protein and C3 [Complement], are related and altered in polycystic ovary syndrome. A case-control study including forty-two women diagnosed with PCOS, according to Rotterdam criteria, and forty-two healthy controls, matched for body mass index [BMI] and age, was conducted in 2012. C-Reactive protein [CRP] and C3 were assessed as possible determinants of the homeostasis model assessment [HOMA] index. Independent-sample t-test was used to compare the means of the groups in age, BMI, C3, FBS and BS 2hpp [2 hr postprandial glucose] and for CRP, Fasting Insulin and 2 hr Plasma Insulin and HOMA index. Mann-Whitney test and Pearson correlation were used for analyzing the data. The p<0.05 was considered as statistically significant. Levels of plasma CRP [p=0.039], 2 hr pp [p=0.045], Fasting Insulin [p=0.002], 2 hr Plasma Insulin [p=0.002] and HOMA index [p=0.002] were significantly higher in PCOS patients. But C3 was not significantly higher in cases [p=0.885; CI: 95%]. There was no significant correlation between C3 and CRP with HOMA index. CRP increased significantly in patients with PCOS and was associated with insulin resistance, the most probable cause of PCOS. However, such an association was not found in C3