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"nBackground: Langerhans cell histiocytosis (LCH) is a group of idiopathic disorders characterized by the proliferation of specialized bone marrow-derived Langerhans cells and mature eosinophils. The estimated annual incidence ranges from 0.5-2 cases per 100,000 persons per year. The pathogenesis of LCH is unknown. The prevalence of LCH seems to be higher among whites and males. The most common complaints at presentation are those related to bone lesions. Treatment consists of surgery, chemotherapy and radiotherapy alone or in combination. The age of onset varies according to the variety of LCH. Solitary lesions may occur in bones or skin. Cutaneous lesions present with firm, painless papulonodules or vesicles. "nCase report: This six-month-old baby presented with firm papulonodules on her temporal skin, but fortunately her other organs were healthy. She underwent two surgeries, separated by a one-month interval. Due to local recurrence after a short period of time, she underwent a 10-Gy dose of radiation. Her response proved good during follow-up. "nConclusion: Radiotherapy is good for controlling local recurrence in LCH, with few sequelae related to treatment.

Background: Mucositis [bucal Mucous inflamation] is the most common complication resulting from the radiotherapy in tumors of head and neck. These malignancies are often curable through radiotherapy. This complication, however, may impair the treatment process and cause malnutrition. So far no medicine has been Known to prevent this complication. Vitamin E is a stabilizer of cell membrane and is also used in mucositis treatment. The survey of oral vitamin E effect on mucositis prophylaxis in radiotherapy of head and neck malignancies. Materials and Methods: Seventy patients afflicted with head and neck malignancies referring to Imam Khomeini Hospital were randomly divided into 2groups, two of whom died during treatment process. The first group (The case group consisting of 34 patients) Consumed oral vitamin E 200 mg daily for seven days. The second group (The control group) did not use any medicine at all. The two group underwent radiotherapy. They were compared and contrasted as to mucositis severity and dysphagia during treatment. Results: In the first group, since the fourth week up to the end of the treatment, there was a lower frequency and grade of mucositis in contrast with the control group. In the fourth week, the grade two mucositis in the first group (Case group) was 20.6% and 47.5% in the control group the difference was statistically significant (P=0.024). There was also a lower frequency and grade of dysphagia in the case group since the fourth week versus the control group. In the fourth week, moderate dysphagia was 29.4% in the case group and 55.9% in the control group. The difference was statistically significant (P=0.023). Conclusion: Oral vitamin E has Proved to be effective in the Prophylaxis of Moderate and severe mucositis and dysphagia resulting from radiotherapy. It is advisable to conduct more research with more cases, lengthier duration and heavier doses.

Abstract Background: Postoperative nausea and vomiting (PONV) is one of the most common complications in the patients undergoing strabismus surgery. The aim of current study was comparing supplemental 80% and 40% oxygen on reducing postoperative nausea and vomiting in the pediatrics undergoing strabismus surgery. Materials and Methods: In this clinical trial study, 100 pediatric patients scheduled for strabismus surgery under general anesthesia were allocated randomly into two parallel supplemental 80% and 40% oxygen groups during surgery. PONV in patients was compared until 24hrs after operation. Results: In the first 6hrs postoperatively, PONV in the supplemental 40% and 80% oxygen groups were 48.8% and 30.6% respectively, also were 20.8% and 12.2% in the 6 to 24hrs postoperatively. Therefore, there were no significant differences between both groups in regarding of PONV in 6hrs and 6 to 24hrs postoperatively (p values were 0.18 and 0.25, respectively). Conclusion: According to our results, there is no any difference between 40% and 80% oxygen postoperatively in the pediatrics undergoing strabismus surgery.

مقدمه: وازواسپاسم مغزی به عنوان یکی از اصلی‌ترین علل مرگ و میر و ناخوشی در بیماران دچار خون‌ریزی ساب‌آراکنویید (Subarachnoid hemorrhage یا SAH) شناخته شده است. هدف از این مطالعه، بررسی اثربخشی تزریق پاپاورین در فضای ساب‌آراکنویید بر مرگ و میر و ناخوشی در بیماران دچار خون‌ریزی ساب‌آراکنویید خود به خودی همراه با وازواسپاسم مغزی بود. روش‌ها: این مطالعه از نوع کارآزمایی بالینی کنترل شده بود که طی سال‌های 89-1388 در بخش جراحی مغز و اعصاب بیمارستان الزهرا (س) در اصفهان انجام شد. پنج بیمار مبتلا به خون‌ریزی ساب‌آراکنویید خود به خودی همراه با وازواسپاسم مغزی که به علت هیدروسفالی نیاز به ونتریكولوستومی داشتند، وارد گروه مداخله شدند و تحت ونتریکولوستومی و تزریق پاپاورین در فضای ساب‌آراکنویید (40 میلی‌گرم هر 12 ساعت تا 72 ساعت) قرار گرفتند. 10 بیمار مبتلا به خون‌ریزی ساب‌آراکنویید خود به خودی همراه با وازواسپاسم مغزی با یکسان سازی بر اساس سن، جنس، بیماری زمینه‌ای و شدت خون‌ریزی برای شرکت در گروه شاهد انتخاب شدند و تحت درمان استاندارد قرار گرفتند. مرگ و میر، سطح هوشیاری (Glaco coma scale یا GCS) و تغییرات معاینات عصبی در بیماران قبل و دو هفته پس از جراحی سنجیده و مقایسه شد. یافته‌ها: طی مطالعه، 9 زن و 6 مرد با میانگین سنی 8/12 ± 0/54 سال بررسی شدند. مشخصات اولیه بین دو گروه تفاوت معنی‌داری نداشت (05/0 < P). دو هفته پس از جراحی، تنها 1 نفر (20 درصد) در گروه شاهد فوت کرد که تفاوت معنی‌داری با گروه مداخله، که همگی زنده ماندند، نداشت (667/0 = P). در گروه مداخله میانگین GCS بعد از دو هفته نسبت به بدو ورود بهبودی معنی‌داری داشت (از 6/1 ± 2/8 به 6/2 ± 8/12؛ 008/0 > P)، در حالی که تغییر معنی‌داری در گروه شاهد دیده نشد (از 8/1 ± 8/8 به 8/1 ± 0/9؛ 729/0 = P). در گروه مداخله در یک بیمار همی‌پلژی سمت راست پس از دو هفته به همی‌پارزی بهبود یافت اما در گروه شاهد بهبودی در معاینات عصبی ایجاد نشد. نتیجه‌گیری: تزریق پاپاورین در فضای ساب‌آراکنویید در بیماران دچار خون‌ریزی خود به خودی ساب‌آراکنویید همراه با وازواسپاسم مغزی در بهبودی کلینیکی تأثیر چشمگیری داشت اما در بهبود ضایعات عصبی تأثیری نداشت. انجام مطالعات با حجم نمونه‌ی بیشتر و پی‌گیری طولانی‌تر در آینده توصیه می‌شود.