Application of Aloe vera cream on the surgical site is effective in reducing postoperative pain both on resting and during defecation, healing time, and analgesic requirements in the patients compared with the placebo group.

IRCT201404013014N8.

Background and objective As a chronic inflammatory disease of an unknown origin, the treatment of granulomatous mastitis has always been controversial. According to some researchers, surgical treatment and certain medications, especially steroids, are more effective in treating the disease. This study aimed at evaluating the results of treatment in a group of patients with granulomatous mastitis. Materials and methods This longitudinal cohort study evaluated the treatment outcomes of 87 patients with pathology-confirmed granulomatous mastitis referred to the surgical clinic of Central Hospital in Sari, Iran. Demographic, clinical, and pathological information, treatment methods and results, and the recurrence rate were analyzed. Findings A total of 87 female patients with granulomatous mastitis aged 22–52 years with a mean age of 34 years were evaluated. All patients had palpable masses; the breast masses were painful in 48.3% of patients, and 55.2% of patients suffered from erythema and inflammation, and8% had fistulas and ulcers at the inflammation site. The patients were followed-up for an average duration of 26 months (8–48 months) after treatment and recovery. The overall recurrence rate was 24.1%, and the recurrence rate was 29.4% in patients underwent surgery, 34.8% in patients received high-dose prednisolone, and 17% in those received low-dose prednisolone together with drainage (p < 0.001). Conclusions According to the results, the low-dose prednisolone plus drainage was more effective with a lower recurrence rate than only surgical excision or high-dose prednisolone. In fact, the use of minimally invasive methods such as drainage plus low-dose steroids is a more effective method with fewer side effects than the other two methods.

Oral Gastrografin®, a hyperosmolar water-soluble contrast medium, may have a therapeutic effect in adhesive small bowel obstruction. However, findings are still conflicting, as some authors did not find a therapeutic advantage. So, this prospective, randomized, and clinical trial study was designed to determine the value of Gastrografin in adhesive small bowel obstruction. The primary end points were the evaluation of the operative rate reduction and shortening the hospital stay after the use of Gastrografin. A total of 84 patients were randomized into two groups: the control group received conventional treatment, whereas the study group received in addition of 100 mL Gastrografin meal. Patients were followed up within 4 days after admission, and clinical and radiological (if needed) improvements were evaluated. Although the results showed that Gastrografin can decrease

Introduction: Laparoscopic cholecystectomy as a gold standard for treatment of patients with acute cholecystitis is associated with complications. Some complications are dependent on the methods of surgery and applying clips. Aim of the research:To compare complications following concurrent and separate ligation of cystic duct and artery and evaluate the costs of each procedure. Material and methods:The study was designed as a prospective cohort. Patients with acute cholecystitis due to gallstones were included. They were assigned into two groups: 1) separate ligation group and 2) concurrent ligation group. Routine laparoscopic surgery was performed. For the first group, the hilum was dissected and the cystic duct and artery were ligated separately. For the concurrent group, the cystic duct and artery were ligated together. Intra-operative and post-operative data were measured. Results: A total of 122 patients were enrolled in this study. The median lengths of symptoms to surgery were 3.23 days for the concurrent group versus 3.67 days for the separate group (p = 0.004). There was no statistically significant difference in post-operative complications. One patient in the concurrent group had biliary colic and cholestasis due to a stone in common bile duct managed by endoscopic retrograde cholangiopancreatography. Twice as many clips were used in the separate group than in the concurrent group (six clips vs. three clips, p ≤ 0.001). Further analyses revealed that operation time and costs were significantly higher in the separate ligation group. Conclusions: The mean duration of surgery and number of clips applied for ligation were higher in the separate ligation group. Concurrent ligation seems to be associated with similar complications and therapeutic outcomes compared to separate ligation and is cost effective for replacement of the routine procedure in the future. StreszczenieWprowadzenie: Cholecystektomia laparoskopowa -złoty standard w leczeniu pacjentów z ostrym zapaleniem pęcherzyka żółciowego -wiąże się z występowaniem określonych powikłań. Niektóre z nich zależą od stosowanej metody operacyjnej i zakładania klipsów. Cel pracy: Porównanie powikłań po jednoczesnym i oddzielnym podwiązaniu przewodu pęcherzykowego i tętnicy pęcherzykowej oraz ocena kosztów związanych z tymi procedurami. Materiał i metody: Badanie przeprowadzono z wykorzystaniem prospektywnej kohorty pacjentów. Do analizy włączono chorych z ostrym zapaleniem pęcherzyka żółciowego wywołanym kamicą żółciową. Uczestników podzielono na dwie grupy w zależności od rodzaju podwiązania: 1) oddzielne podwiązanie i 2) jednoczesne podwiązanie. Wykonano rutynową operację laparoskopową. W pierwszej grupie wypreparowano wnękę oraz oddzielnie podwiązano przewód pęcherzykowy i tętnicę pęcherzykową. W drugiej grupie przeprowadzono jednoczesne podwiązanie przewodu pęcherzykowego i tętnicy pęcherzykowej. Zebrano odpowiednie dane śród-i pooperacyjne.Concurrent ligation of cystic duct and cystic artery versus separate ligation during laparoscopic cholecystectomy ...