One of the most common postoperative problems is nausea and vomiting. Although using some anesthetic materials has been considered as the mainstay of this phenomenon, the exact factors are not known. Because of several morbidities associated with postoperative nausea and vomiting (PONV), its prevention and treatment has been a challenge for physicians, so several drugs have been recommended for this purpose. Based on the documented antiemetic specificity of ginger, we evaluated and compared the effects of preoperative administration of ginger on PONV with ondansetron administration as the standard medication. The participants included 100 patients with cholelitiasis who were candidate for laparoscopic cholecystectomy. Patients were divided into two groups: group A comprised 50 patients who received 500 mg oral ginger 1 h before surgery, and group B included 50 patients who received 4 mg intravenous ondansetron before completion of surgery. Antiemetic efficacy was assessed by visual analogue scale scores of nausea intensity at 0, 4, 8, 16, and 24 h after surgery and frequency of vomiting during the evaluation period. Although multifactor analysis showed that nausea severity was significantly lower in the ginger group, the data indicated that except 16 h after operation, the differences between two groups in the frequency of vomiting was not significant. In conclusion, though complementary studies are needed to have a strong suggestion, based on this study, we recommend administration of oral ginger 1 h before operation to control the severity of PONV in patients undergoing laparoscopic cholecystectomy.

The objective of this work was to investigate the influence of delamination degree of the graphite on the mechanical properties of glass fiber/epoxy composite. To aim this, graphene and highly expanded graphite (HEG) nanofillers were synthesized using intensive ultrasonic method and were added to the epoxy and also glass fiber/epoxy composite, separately. Subsequently, tensile, flexural and impact strength of prepared samples were studied. Furthermore, the lateral size and dispersion quality of synthesized fillers in the epoxy matrix was inspected through using field emission scanning electron microscopy. Mechanical results demonstrated an enhancement by addition of both synthesized nanofillers to both nanocomposites and hybrid‐composites. Highest increment rate of tensile strength was related to the nanocomposites containing 0.5 wt% nanofillers in which 61 and 51% enhancement for graphene nanoplate and highly expanded graphite loaded samples, respectively, was observed compared with the neat epoxy. It was found that, degree of delamination and dispersion of graphite platelets has a fundamental influence on the mechanical properties. In addition, fracture surface of epoxy nanocomposites and hybrid‐composites were inspected to study the toughening mechanism. POLYM. COMPOS., 39:E2460–E2471, 2018. © 2018 Society of Plastics Engineers

No conclusion can be drawn on whether there are any advantages in adjuvant chemoradiotherapy over neoadjuvant approaches. Further confirmatory trials, particularly randomized trials, are necessary before any recommendations can be made.

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Biliary leakage after T-tube removal is an important complication which can be lethal especially in patients who received immunosuppressant agents. The purpose of the study is to determine a method which can evaluate the completion of tract formation in high-risk patients. Participants include 46 patients who were candidates for open cholecystectomy and common bile duct (CBD) exploration and T-tube insertion. Twelve of patients received corticosteroids and were divided into two groups. In the first group, T-tube was removed conventionally, but in the other group, we performed a "fistulography" 1 month postoperative to evaluate maturity of tract between CBD and the skin. Biliary peritonitis was seen in half of patients who are managed conventionally, but no complication was detected in patients who underwent fistulography. Fistulography is suggested to be done before T-Tube removal in immunocompromised patients in order to detect tract formation, which is effective in reduction of postremoval complications.

Background: One of the major challenges faced by the treatment planning teams is how to manage postoperative pain. Previous studies agreed upon the effects of preoperative administration of nonsteroidal anti-inflammatory drugs on postoperative pain, but all have focused on patients with surgical noninflammatory diseases (ie, inguinal hernia or breast biopsy). The aim of this study was to evaluate the effects of rectal indomethacin on reducing postoperative pain in patients with acute appendicitis.Methods: It is a simple randomized, clinical trial including 200 patients with acute appendicitis who were divided into two groups (A1 and A2). The case group (A1) received 100 mg rectal indomethacin during 2 hours before the operation. Pain intensity was assessed in all patients using a visual analog scale (VAS). Similarly, total dosage of meperidine analgesic medication and postoperative time to use of rescue analgesia were evaluated.Results: Patients who received preoperative rectal indomethacin (A1) showed a significant reduction in the VAS score. Also, a reduction in total dose of meperidine and longer time to use of rescue analgesic medication were observed in A1 group.Conclusion: Preoperative administration of rectal indomethacin in acute appendicitis reduces postoperative pain.