مجله دانشکده پزشکی اصفهان
پیاپی 586 (هفته دوم مهر 1399)

Obesity is one of the most common problems in community. Bariatric surgery is widely used to treat obesity. The aim of this study was compare the weight loss and body mass index (BMI) in obese patients undergoing single bariatric surgery with Single anastomosis gastric bypass (SAGB) with 3.5 mm linear stapler anastomosis with 30 mm and 45 mm diameters.

In a randomized clinical trial study in 2019 in Alzahra and Kashani hospitals in Isfahan, Iran, 80 patients undergoing gastric bypass surgery with an anastomosis with gastrojejunostomy with linear shear stapler were divided into two groups of 40. The first group underwent SAGB surgery with 30 mm for their diameter of gastrojejunostomy anastomosis, and in the second group, this diameter was considered 40 mm. Patients were followed for 6 months after surgery, and the amount of weight loss and BMI changes were determined and compared in two groups.

The mean decrease of BMI in gastrojejunostomy diameter of 30 and 45 millimeters was 12.79 ± 4.79 and 12.37 ± 5.37 kg/m2</sup>, and the decrease of BMI was significant in both groups (P < 0.001), but no significant difference were seen between the two groups (P = 0.71).

The results show that gastroesophageal anastomosis with both diameters of 30 and 45 mm reduce the weight of patients during the next six months of operation, and there is no difference between these two diameters of anastomosis.

Recently, spray cryotherapy has been used in otorhinolaryngology surgeries. Therefore, due to limited studies in this field, this study aimed to evaluate the effect of spray cryotherapy on tissue repair after endoscopic sinus surgery in patients with nasal polyposis, and compare this method with fluticasone and normal saline spray.

In this clinical trial study, 45 patients with nasal polyps were enrolled according to the inclusion criteria of the study. Then, the patients were randomly assigned into three equal groups. The first group was treated with spray cryotherapy, the second group was treated with fluticasone spray, and the third group received normal saline spray after the operation with four puffs for each group. It should be noted that fluticasone spray was maintained for two weeks after surgery for the three groups. Subsequently, the results of this study were evaluated using Sino-nasal Outcome Test (SNOT-22) questionnaire at intervals of one and three months after the surgical operation.

 The mean SNOT-22 score after the surgery significantly decreased in the three groups. There was a significant difference between the three groups concerning the SNOT-22 scores at intervals of one and three months after the surgery, as the SNOT-22 score in the cryotherapy group was lower than the other groups (P < 0.05).

Using spray cryotherapy is a safe and effective method after endoscopic sinus surgery compared to the corticosteroid and normal saline spray.

Thyroid cancer is one of the most common secondary malignancies as a result of receiving therapeutic doses to the head and neck. In this study, the probability of secondary thyroid cancer risk due to neutron contamination of 15 MV Siemens Linear Accelerator (LINAC) in brain tumor 3D-Conformal Radiation Therapy (3D-CRT) was calculated.

Neutron fluence and neutron dose were measured at different points at the treatment table using an energy-independent neutron detector consisting of a sphere moderator and a Boron Trifluoride (BF3</sub>) counter, and the neutron dose equivalent to the thyroid was determined to calculate the probability of secondary cancer risk.

The neutron dose equivalent was obtained at the central axis (0.304 mSv/Gy) and at 4 cm (0.285 mSv/Gy), 15 cm (0.229 mSv/Gy), 45 cm (0.125 mSv/Gy), and 150 cm (0.02 mSv/Gy) inferior. The neutron dose equivalent reaching the thyroid for the total prescribed dose was 12.366 mSv. According to that, the probability of secondary thyroid cancer risk was obtained as 0.001%.

The thyroid dose in high-energy radiation therapy of brain tumor cannot cause significant biological damage. Therefore, the risk of secondary thyroid cancer due to neutron contamination is relatively low.