The effect of oral zinc sulfate on prevention of chemotherapy-induced oral mucositis in breast cancer patients treated with adriamycin and cyclophosphamide; a double-blind randomized clinical trial

Introduction: One of the most important complications faced by cancer patients is chemotherapy-induced oral mucositis (CIOM). In addition, the role of orally used zinc sulfate in its prevention and treatment is still a controversial issue and the results in this regard have not been conclusive. Objectives: Evaluation the effect of zinc sulfate supplement on prevention of CIOM in breast cancer patients treated with adriamycin and cyclophosphamide was the aim of this study. Patients and Methods: The current double-blind randomized clinical trial was conducted on 87 patients with breast cancer. Consumption of two oral zinc sulfate tablets and two placebo tablets with food was prescribed in the case (44 patients) and control (43 patients) groups, respectively. During the 4 cycles of chemotherapy, the incidence and severity of CIOM, the onset time of mucositis from the start of chemotherapy, the severity of pain, and the severity of dry mouth were recorded. In addition, the patients’ quality of life was recorded using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30). Results: Findings revealed that the severity of CIOM in the first, second, and third sessions with the values of 1.22±1.01, 1.18±0.97 and 1.02±0.79, respectively, was significantly lower in the case group than the control group with the values of 1.91±0.89, 1.80±0.92, and 1.67±0.85, respectively (P0.05). Conclusion: Oral zinc sulfate had a significant role in reduction of the incidence and severity of CIOM, the severity of dry mouth, and the severity of pain in the initial sessions of chemotherapy. However, no significant difference was in postponing the incidence of CIOM and the quality of life of patients in the case group. Trial Registration: This trial protocol was approved by the Iranian Registry of Clinical Trials (identifier: IRCT20150304021338N2; https://irct.ir/trial/51105, ethical code# IR.MUI.MED. REC.1399.277)

Effectiveness of Minimally Invasive Plate Osteosynthesis (MIPO) on Comminuted Tibial or Femoral Fractures

Background: Comminuted fractures happen frequently due to traumas. Fixation without opening the fracture site, known as minimally invasive plate osteosynthesis (MIPO), has recently become prevalent. This study has been designed to assess the outcomes of this treatment for tibial and femoral comminuted fractures. Methods: A total of 60 patients with comminuted femoral or tibial fractures were operated with MIPO method in this cross-sectional study at Alzahra university hospital in 2015. Eleven patients were excluded due to lack of adequate follow-ups. Patients'data including union time; infection in the fractured site; hip and knee range of motion; and any malunion or deformities like limb length discrepancy were collected after the surgery in every session. Results: Among 32 femoral and 17 tibial fractures, union was completed in 48 patients, while only one patient with femoral fracture had nonunion. The mean union time was 18.57 +/- 2.42 weeks. Femur fractures healed faster than tibia (17.76 +/- 2.36 compared to 19 +/- 2.37 weeks, respectively, P=0.09). None of the patients suffered from infections or fistula. The range of motion in hip and knee remained intact in approximately all patients. Malunion happened in 3 patients; 100 internal rotation in 1 patient; and 1 cm limb shortening in 2 patients. Conclusion: According to the result of this study, MIPO is a simple and effective method of fixation with a high rate of union as well as minimal complications for comminuted fractures of long bones. Infection is rare, and malunion or any deformity is infrequent. MIPO appears to be a promising and safe treatment alternative for comminuted fractures