Bahador M, Sardari Kermani M, Amoozegar Hashemi F,
Volume 62, Issue 2 (12 2004)
Abstract
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.
Bahador M,
Volume 64, Issue 9 (1 2006)
Abstract
At the middle of the 20th century, autopsy has a fundamental role in medical education in Iran, guided by the influential Oslerian philosophy “as is your pathology so is your medical practice”. Students not only attended autopsies, but also had learnt to conduct them. In contrast, today the use of autopsy in medical education is falling down to death. Although this falling is worldwide, but the situation in Iran is much worse. Rarely Iranian medical schools deal with educational autopsy and some of them are quite unfamiliar with autopsy. There are several reasons for this declining including sophisticated medical education with autopsy, community attitudes ,clinicians’ and pathologist’ reluctance, hospital concern about legal action, religious attitudes, consent from the family and funding priorities.
Even with new diagnostic modalities, autopsy remains an important tool for quality and safety assurance. A systematic review of reports on autopsies from USA, European and Australian hospitals, revealed 9 to 40% (on average 23.5%) of clinically missed diagnoses and managements involving the principal or underlying cause of death.
The key roles of hospital autopsies are Improving safety and quality in diagnosis and treatment, Providing benefits to families, Advancing understand-ing of disease, Allowing good programming for emerging disease and frequently seen disease, and Educating medical and allied health professionals.
We have concluded that, reversing the decline of autopsies will require cooperative action at several levels of the healthcare system, particularly including clinicians and pathologists and also governmental and financial bodies and legal authorities.
