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.

Although perforation of the esophagus, in the anterior cervical spine fixation, is well established, cases with delayed onset, especially cases that present pseudodiverticulum, are not common. In addition, management of the perforation in this situation is debated. Delayed esophageal pseudodiverticulum was managed in two patients with a history of anterior spine fixation. Patients were operated on, the loose plate and screws were extracted, the wall of the diverticulum was excised, the perforation on the nasogastric tube was suboptimally repaired, and a closed suction drain was placed there. The NGT was removed on the 7th day and barium swallow demonstrated no leakage at the operation site; therefore, oral feeding was started without any problem In cases with delayed perforation, fistula, or diverticulum removal of anterior fixation instruments, gentle repair of the esophageal wall without persistence on definitive and optimal perforation closure, wide local drainage, early enteral nutrition via NGT, and antibiotic prescription is suggested.

Introduction: Castleman's disease is a rare nonclonal lymphoproliferative disorder of unknown etiology that most commonly affects the mediastinum. It is classified into two clinical subtypes: A localized (unicentric) subtype and a multifocal (multicentric) subtype. This case report presents an adolescent with unicentric mesenteric Castleman's disease, which is very rare. Case Presentation: A 14-year-old girl presented to our center with chronic left flank pain. She also reported frequent episodes of small-volume vaginal bleeding outside her menstrual period. Initially, she was treated for several weeks with a possible diagnosis of dysmenorrhea due to an ovarian cyst. However, due to the lack of response to treatment and persistent symptoms, further investigation was conducted. Abdominal and pelvic ultrasonography revealed a round, hypoechoic, and heterogeneous mass measuring 22 × 35 mm in the left mesentery with regular margins. Pathological examination confirmed Castleman's disease of the hyaline-vascular type. The patient was discharged in good general condition and with stable vital signs. During follow-up, her abdominal symptoms and bleeding resolved, and no lesions were detected on ultrasonography and CT scans at 6 and 12 months. Conclusions: Mesenteric Castleman's disease is rare and presents a diagnostic challenge. This disease should be included in the differential diagnosis of abdominal tumors, even in symptomatic cases. The treatment of choice for unicentric cases is surgery.

Lymphedema is a ubiquitous chronic disease with various suggested treatment options, but no definite treatment. Using (Sequential) Intermittent Pneumatic Compression (SIPC) is one of the most appropriate non-surgical treatments without any noticeable complications. In this study, we evaluated the serum lipids changes following SIPC. Participants included 40 lower limb lymphedema patients who underwent High Pressure SIPC for a period of 48 hrs. Pre and Post SIPC serum lipids changes were evaluated. Though, there was some increase in the serum level of cholesterol and triglyceride, none of the patients had the values above the normal range. We concluded that, the fluid entering the serum during SIPC, contain large molecules such as lipids, which increases serum lipid levels. However this phenomenon does not have any significant complication for the patients.