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Aim: Thyroid nodules are one of the most common clinical findings, with a prevalence of 68% in adults. Thyroid cancer is the fifth most common cancer in women. background: Thyroid nodules are one of the most common clinical findings with a prevalence of 68% in adults and thyroid cancer is the fifth most common cancer in women. Introduction: The purpose of this study is to evaluate the diagnostic efficacy of Thyroid Imaging Reporting and Data Systems proposed by the American College of Radiology (ACR-TIRADS) for the diagnosis of malignancy in surgically resected thyroid nodules Methods: In this retrospective study, patients who underwent thyroid nodules resected surgically from 2018-2020 were included. Before resection, an ultrasound was performed for TIRADS scores, and after resection histopathology, thyroid mass was obtained. The outcomes of the two systems were statistically compared. method: In this retrospective study patients who underwent thyroid nodules were resected surgically from 2018-2020 were included. Prior to resection, ultrasound was performed for TIRADS scores and after resection histopathology thyroid mass was obtained. The outcomes of the two systems were statistically compared. Results: The mean age of the 146 included patients was 47.6 ± 14.08 years, of which 109 (74.7%) were female. Based on TIRADS, 47 patients (32.2%) were in TI-RADS TR3, 36 patients (24.7%) were in TIRADS TR2, 34 (23.3%) in TIRADS 4, 24 (16.4%) in TIRADS TR5 and 5 patients (3.4%) were in TIRADS TR1. The overall sensitivity was 79.9% when ACR-TIRADS TR4 was set as a diagnostic cutoff value. Considering the total of TIRADS TR4 and TIRADS TR5 as predictors of thyroid malignancy, the sensitivity was 74.5% and the specificity was 76.8%. The positive and negative predictive value was 60.3% and 76.8%. Conclusion: ACR-TIRADS 4 and 5 can be considered good predictors of malignancy in thyroid nodules. More studies, including larger samples, are required to obtain a better conclusion. other: Due to the different results obtained regarding the sensitivity, specificity, and accuracy of the ACR-TIRADS guideline in various studies, further studies with a much higher number of samples and considering the size of the nodules can be very important.

Backgrounds:: Acute appendicitis has been considered as the most common non-obstetric indication that requires surgical intervention in pregnant women. Objective: The aim of this study is to compare clinical manifestations and para-clinical indices between pregnant and non-pregnant patients who have undergone appendectomy. Methods:: In this prospective cohort study, 57 pregnant and non-pregnant women presenting appendicitis were compared in terms of diagnostic indicators, histopathological characteristics and laboratory findings. Results:: Periumbilical region was the point of initiation of the pain; however, it was more prominent in non-pregnant women. Similarly, tenderness in RLQ (right lower quadrant) of the abdomen was more detectable in the non-pregnant group, and some of the cases showed no rebound tenderness. Pregnant women with appendicitis presented an abnormal increase in the WBC count. Conclusion:: Pregnancy and appendicitis-related signs and symptoms have similarity among them. Due to pregnancy, the physical examination might not present an exact diagnosis; therefore, pregnant women susceptible to have appendicitis must undergo a complete and careful on-time examination that includes ultrasound and labs.

Objectives: The aim of this study is to evaluate the diagnostic significance of CA 125 in Acute Appendicitis (AA) along with the changes in its levels about clinical symptoms and lab findings. Methods: Patients referred at the emergency department of Madani hospital with the suspicion of AA and right iliac fossa pain were enrolled in this study. Preoperative CA 125 levels along with C-reactive Protein (CRP) and complete blood count were obtained. Lab findings, signs and symptoms were recorded for all the patients. Statistical analysis was conducted based on CA 125 < 16.4 U/mL and ≥ 16.4 U/mL using the logistic regression model, where variables such as fever, anorexia, CRP and Erythrocyte Sedimentation Rate (ESR) were added to the model. Results: Of 207 patients with the mean age of 26.55 ± 0.967 years, 48.8% of them were males and 51.20% were females. 122 of the total patients had CA 125 ≥ 16.4 U/mL. Anorexia was significantly associated with increased levels of CA 125. CA 125 was 2.14 times higher in patients presenting anorexia. However, ESR, CRP and fever were not associated with the elevation of CA 125. Based on the contour plot, it was deduced that leukocytosis at its lowest and erythrocyte sedimentation rate at its highest levels is associated with the maximum concentration of serum CA 125. Conclusion: Based on the findings from this study, CA 125 cannot be considered as a reliable diagnostic variable for acute appendicitis. Levels of CA 125 may vary with the severity of AA.

Objectives Patients presented with penetrating trauma are immediately given an initial x-ray scan followed by the desired treatment. Intercostal nerve block in chest trauma patients is effective in pain management. The aim of this study is to investigate the need of second chest x-ray in penetrating chest trauma patients, following intercostal nerve block and evaluation of pain and other clinical parameters. Method In this a randomized controlled trail, 100 patients with thoracic trauma were examined from June 2019–December 2019. All patients who entered the study underwent an intercostal nerve block by 5 mg of lidocaine. The results from normal and abnormal chest x-ray groups were compared following the block, in terms of the VAS (Visual Analogue Scale) score and hemodynamic parameters. Result Among the two groups, normal second x-ray vs delayed hemopneumothorax, systolic blood pressure, rate of respiration and heart rate were not significantly at the time of admission and the time following the nerve block. However, this difference was significant in terms of visual analog scale score among the two groups.We also report that the VAS difference of more than 2.5 points has the specify of 76.5 and a sensitivity of 92.8 for the diagnosis of normal/stable patients. Conclusions Intercostal nerve block reduces pain in patients who are not presented with hemopneumothorax, whereas, patients otherwise are presented with the significant pain. Second x-ray in patients with reduced pain in response to the nerve block, might not be necessarily required.

Objective Prophylactic antibiotics are administered preoperatively to reduce the incidence of surgical site infection. The aim of this study was to determine the pattern of administration of prophylactic antibiotic among elective surgery patients in accordance with national and international guidelines. Method This retrospective descriptive was conducted on the patients who underwent elective surgery at (XXX) Educational and Medical Center. Patients’ file was used to obtain the following data: demographic information including patients' age and gender, prescribing prophylactic antibiotics, type, dose and time of administration with the indications mentioned in the guidelines for prevention of SSI of the World Health Organization (2017) and the instructions of the Ministry of Health and Medical Education of Iran compared. Data were analyzed using SPSS statistical program. Result The time, type, dose, duration and intervals of prophylactic antibiotic administration in the present study were 64.8%, 42.5%, 36%, 52.8% and 32%, respectively, according to national guidelines and were 58.8%, 40%, 31.5%, 45.5% and 28%, respectively, according to international guidelines. Administration of prophylactics in terms of time dose, duration and intervals in accordance with national and international guidelines were not associated with the type of surgery, p Conclusions The results of the present study showed that the type, duration and intervals of prophylactic antibiotic administration varies in accordance national and international guidelines. Further studies are required to determine the effects of these parameters under national and international guideline on postoperative outcomes like surgical site infection.

Background Trauma is known as a third leading cause of mortality among all-aged patients. Objective The aim of this study is to investigate pre-trauma physiological factors and trauma-related factors that can increase the risk of mortality among the adult and geriatric patients. Method In this longitudinal data analysis study, 500 non-penetrating adult trauma patients who were referred to (Shahid Madani Hospital) from January 2019–December 2019 were enrolled. Information such as age, sex, occupation, place of residence, hospitalization and surgical history, underlying illnesses, medications (such as antihypertensive drugs, etc.), lab findings (complete blood cell and creatinine levels) were recorded in the form of a questionnaire. The patients were divided in group A (aged 65 and above) and group B (aged below 65 years). The data obtained was analyzed statistically using SPSSv18. Result The mean age of all patients under study was 51.6 years. Among all participants, 68% (341) were male and 32% (159) were female. Regarding the cause of trauma, group A had significantly greater incidence (p-value = 0.001). The two groups were also significantly different in terms of the region of the injury (p-value = 0.014). Furthermore, underlying diseases were also statistically significant among the two groups (p-value = 0.0093). There was a significant difference between the two groups in terms of smoking and drugs (p-value = 0.01 and 0.001, respectively). Finally, the mortality rate in patients older than 65 years old (4.3%) was significantly higher than those in patients under the age of 65 years (2.9%) (p-value = 0.0001). Conclusion The results of this study showed that among the trauma patients aged below 65 years and those aged 65 years and above, underlying illness, mortality rate, usage of drugs, cause of trauma, type of injury, vital signs, white blood cell count and platelet count, hemoglobin and serum creatinine vary significantly.

Background: Hydatid cysts are one of the serious complications following echinococcus infection. The liver and the lungs are the most affected organs, respectively. The severity of the disease is associated with the increase in the number and the size of the cysts, cysts rupture, and systemic effects. The aim of this study is to evaluate prognostic factors that are associated with the increased incidence of postoperative complications following pulmonary hydatid cyst surgery. Methods: Patients referred to Madani hospital from 2014-2018, presenting pulmonary hydatid cysts were included in this study. All the patients were evaluated based on the following parameters: age, gender, location and size of the cysts, rupture status of the cysts (intact or perforated), type of surgical intervention (capitonnage or segmentectomy) and Erythrocyte Sedimentation Rate (ESR). The factors were then compared with postoperative complications. Statistical analysis of the data obtained was conducted using R-software Results: Of 76 patients enrolled in our study, 52.63% were males and 47.36% were female. Air leak complication was reported in 13.15% of the patients and 3.94% of the patients were presented with pleural effusion. Postoperative complications were significantly associated with the perforated (ruptured) cysts p= 0.001, segmentectomy p= 0.013, giant hydatid cysts p= 0.007 and ESR p= 0.014. However, the side of the lung was not significantly related to postoperative complications. Conclusion: Our study reports that perforated cysts, increased size, segmentectomy and abnormal ESR are likely to increase postoperative complications following pulmonary hydatid cysts surgery. Prospective studies with perioperative parameters and greater sample size can help to deduce better inferences.

Esophageal cancer is one of the most common cancers associated with the high mortality rate. Timely diagnosis and treatment are important to manage the disease and prevent comorbidities. Surgical resection of the tumor and lymph nodes is usually practiced either with or without chemo or chemoradiotherapy. Despite advancements in surgical methods and skills, complex nature of the esophagus and invasiveness of the surgery can lead to serious complications in these patients. In order to predict postoperative outcomes, preoperative examination of the patients, in addition to risk factors, should be conducted. Conclusion: Lastly, early detection of adverse postoperative events may help faster recovery, reduce hospital stay and prevent other morbidities., Highlights • Esophageal cancer (EC) is forth most widespread cause of mortality. • Esophagus is a complex organ with limited abilities of self-repair. • early detection of adverse postoperative events may help faster recovery, reduce hospital stay and prevent other morbidities.

Gallstone ileus is rare and inguinal hernias are common causes of intestinal obstruction but combination of them is a very rare cause of intestinal obstruction. It is accepted that in patients with severe comorbidities surgeons can manage inguinal hernias and gallstone conservatively. In this article we report a patient with gallstone and inguinal hernia that managed with conservatively management because of heart failure but admitted with complication of gallstone and hernia and treated successfully.An 80-year-old woman with a history of heart failure and two bouts of acute cholecystitis, who presented with pain and swelling in the inguinal region and obstructive symptoms. And due to the urgent nature of the condition, she underwent surgery.One of the rare complications of gallstones is cholecystoduodenal fistulas, especially in patients whose episodes of cholecystitis are treated medically. Early diagnosis and appropriate surgical management in these circumstances reduce the mortality and morbidity.

Background: In case of a stab wound to the lower cervical region and upper dorsal region, many organs are prone to damage, including the lung, heart, pericardium, any of the vessels in the thoracic cage, the esophagus or trachea, thoracic duct, and even spinal cord. Case Report: A 19 year-old patient arrived at the emergency department with swollen and painful upper dorsal region between the internal border of the left scapula and T2 vertebra. The patient had a history of a street fight with a stab wound on the corresponding area. Nothing abnormal was found on physical examination, and the patient was stable without any neuroglial deficit. Radiographic imaging demonstrated a foreign body lodged near the vertebra. The patient underwent an operation surgery, and the foreign body was removed without any serious complications. The foreign body was the blade of the stab, which was broken and hidden under soft tissue. Conclusion: According to guidelines for a stab wound to the thoracic, a chest x-ray and exploration of the area must be performed, which were missed in the present case and potentially could lead to serious complications given multiple vital organs in that anatomical region.

Background: Cardiac penetrating trauma is a medical emergency that mostly affects young people. Based on the type of injury and associated complications, it can present as a surgical challenge and can lead to mortality. Objective: The aim of this study is to evaluate the complications of penetrating heart trauma among patients referred to Shahid Madani Hospital. Methods: In this retrospective descriptive study, the data of penetrating cardiac trauma patients referred to Shahid Madani hospital, Karaj, Tehran, from 2016-2019, were investigated. Information, including age, sex, cause of trauma, traumatized area and complications, was extracted and recorded in a data collection form. The data were evaluated statistically using SPSS v18. Results: A total of 44 patients were included in the study, where the mean age of the patients was 25 years. 73.3% of these patients were men and 26.7% were women. Knife stab wounds were the most prevalent cause of the trauma, present in 93.3% of patients. 73.3% of the patients had cardiac tamponade and 20% had a pneumothorax. The right ventricle was the most common site of the injury in 46.7% of the patients. A mortality rate of 3.4% was reported in this study. Conclusion: The results of this study showed that the highest penetrating heart rate trauma occurred among young people, and the most common cause of the trauma was a knife stab. The most common area of the injury was the right ventricular, and cardiac tamponade was the most common complication.

Introduction Coronavirus pandemic-initiated Wuhan city, Hubei Province, China. It mainly involves respiratory system and cause fever, cough. However, it has other manifestations such as GI system, CNS and skin involvement. It is transmitted mostly through respiratory system, but some researchers claim that in can potentially spread by oral, fecal or intestinal gas. During colorectal surgeries such as volvulus sigmoid, surgeons are at risk of exposure to intestinal gas. Case presentation A 57-year-old mentally retarded man came to our emergency department with complain of abdominal pain, constipation, obstipation, nausea, vomiting and abdominal distention. His vital sign was stable and his laboratory data revealed no abnormality. His abdominal x-ray showed intestinal obstruction with suspicious of sigmoid volvulus. His PCR for COVID 19 was positive and his chest CT scan has manifestations of lung involvement. He was proceeded for surgery. Conclusion Owing to odds of spread of coronavirus through intestinal gas, in this case, sigmoid colon was removed without evacuation of intestinal gas., Highlights • Covid-19 involves respiratory system and cause fever, cough. • COVID19 is a strong pathogenic virus which mainly transmit throw respiratory system. • It there are potential way of transmission such as oral-fecal and throw intestinal gas. • We introduce a new technic in sigmoid volvulus surgery to reduce risk of contamination.

Objective Sternal fracture may be associated with major and serious injuries. In this study, the complications associated with isolated sternal fracture in trauma patients are evaluated based on radiographic and cardiac findings. Methods This retrospective study was performed on patients with isolated sternal fractures admitted to the emergency department of (XXX) Madani Educational-Medical. Data regarding demographic information, mechanism of trauma, length of hospitalization, electrocardiography (ECG), cardiac enzyme, and chest radiography were recorded in the questionnaire for each patient. Results The mean age of patients 41.2 + 11.04 years and 63.9% were male. The most common cause of the trauma was car accidents in 41% (25 cases). The mean duration of hospitalization was 1.54 ± 0.90 days. The mechanism of trauma was not associated with x-ray and computed tomography findings, p = 0.53 and p = 0.86, respectively. ECG findings were significantly related to x-ray and computed tomography outcomes, p 0.5 cm and hematoma are likely to require cardiac consultation., Highlights • Sternal fracture may be associated with major and serious injuries. • Approximately, 10% of all trauma cases are blunt trauma. • Patients with isolated sternal fracture and hematoma are likely require cardiac consultation. • The type mechanism of trauma may not predict radiographic findings.

Background Serotonin-containing cells are abundantly found in the appendix. Studies have shown that acute appendicitis is likely to be characterized by altered urinary 5-hydroxyindole acetic acid (5-HIAA), an active serotonin metabolite. The aim of this study is to investigate the diagnostic potential of 5-HIAA as a biomarker for acute appendicitis. Method This cross-sectional study enrolled patients referred at the Madani Hospital, with right iliac fossa pain, suspected to having the acute appendicitis. Before the initiation of the basic treatment and surgery, urine samples were obtained from the patients. Enzyme-linked immunosorbent assay (ELISA) was used for the analysis of 5-HIAA urinary levels. The obtained data were statistically analyzed using SPSS v18. Results Of 129 patients included in the study with the mean age of 29 years, 62 (48.1%) were men and 67 (51.9%) were women. Appendectomy was performed in 96 patients, where 81 cases were that of acute appendicitis. The mean levels of 5-HIAA in acute appendicitis group and in the negative appendectomy group was not statistically significant. The sensitivity of the test was 54.3% based on 7.4 ​μmol/L as cut-off %-HIAA value. Conclusion Our study reports that 5-HIAA urine concentration is not a reliable diagnostic marker for the diagnosis of acute appendicitis.

Background: Evaluation and screening of breast cancer demand significant primary care practice. Breast pain and nipple discharge are the frequent complaints owing to the benign conditions. Objective: In this study, we have investigated the prevalence of breast complaints among women referred to our clinic in Khorramabad, Iran. Methods: This is a cross-sectional study about the prevalence of breast-related complaints in women with breast problems referred to surgery clinic over a period 6 months. Results: Among 151 patients, following outcomes were seen; breast pain (60.3%), lump (27.8%), nipple discharge (4%), lump with pain (4.6%) and other (0.7%). 11 patients were presented lump malignancy (23.9%) including; fibrocystic change (56.5%) and fibro-adenoma (19.6%). Conclusion: This study showed that breast pain was the most common of all complaints and fibrocystic change was the most detected lump-type. Lumps were frequent in single women whereas, mastalgia in common in married women.

Introduction: Acute eosinophilic appendicitis (AEA) is a rare disease with unknown pathophysiology. Case Report: A 42-years old woman with acute abdominal pain referred to emergency department. Appendicitis confirmed after laboratory tests and sonography. She had a history of allergic reaction 45 days ago while tongue and throat were swollen. In alb test WBC was 7700 with PMN 60%, eosinophils 12% and Lymphocytes 28%. Conclusion: Considering hypersensitivity in physical exam is a suitable way to determine and treatment and preventing of consequent gastro-intestinal complications.

Background: Postoperative complications such as; wound infection and scaring are some of the major concerns regarding suturing techniques. This study is designed to evaluate post-operative outcomes of adhering subcuticular sutures in comparison to interrupted suturing method in patients who underwent appendectomy for uncomplicated acute appendicitis. Methods: 240 patients were randomly assigned into two groups; 120 with interrupted and 120 subcuticular sutures after appendectomy, at Shohada Ashayer hospital, Khorramabad, Iran. The prevalence of wound infection, three days after the surgery in the hospital and a week after discharged was determined and evaluated statistically. Results: No wound infection was seen within three days of hospitalization in subcuticular group whereas, 1 patient reported infection in interrupted group, however the difference was not statistically significant. A week after discharge, a patient was reported to have wound infection in subcuticular group and 2 in interrupted group. No significant difference was seen in this regard either. 55 females and 66 males received subcuticular sutures whereas, 74 males and 46 females were given interrupted sutures for wound closing. One male in interrupted and 1 male and female subcuticular group was referred for wound infection, after discharge, respecitvely. Among these groups, no significant differences were seen. In catarrhal appendicitis, infection was reported in interrupted group only which was not statistically significant. Conclusions: Subcuticular sutures provide better cosmetic outcomes without any additional complications in comparison to interrupted sutures.

Introduction: The aim of this study was to evaluate the significance of clinicopathological characteristics of colorectal cancer patients undergoing emergency and elective surgery. Material and methods: In total, 116 tumors from patients treated surgically for colorectal cancer at four hospitals in Tehran between 2008 and 2013 were analyzed in the current study. Results: Our findings revealed that the emergency cases were significantly more likely to have an advanced TNM stage (p = 0.027) and histologic grade (p = 0.01) compared with the elective patients. Furthermore, the nature of surgery was significantly associated with vascular and perineural invasion (p = 0.021; p = 0.001). We also evaluated the association of gender, age, and tumor location with the nature of surgical presentation. However, no association was found between these parameters and the nature of surgery. Emergency was also correlated with greater length of hospital stay and higher rate of admission to the intensive care unit. The mortality rate was 20 in emergency cases, while patients with elective surgery had 5.63 perioperative mortality (p = 0.001). The emergency patients had a higher rate of mortality. Conclusions: Our data indicated that colorectal cancer patients undergoing emergency surgery showed an advanced stage. The emergency patients had a higher rate of mortality than elective cases. Copyright © 2016 Termedia & Banach.

Spinal anesthesia is commonly done using lidocaine 5 and bupivacaine 0/5 in various surgeries. This method is accompanied with many complications including spreading anesthetic level to areas higher than that of local injection site. The aim of this study was to determine the spread of sensory block level in spinal anesthesia by using oflidocaine 5 and bupivacaine 0/5 in surgical patients. In a randomized clinical trial, 300 male and female patients who had undergone surgery by spinal anesthesia were randomly divided into two groups (lidocaine 5 and bupivacaine 0/5). After spinal anesthesia, the sensory block levels were checked every 5 minutes by the way of pin prick test and the results were recorded in a checklist. Data were analyzed using SPSS software. The highest anesthetic level in lidocaine 5 and bupivacaine 0/5 groups was C2 with 0.7 and C5 with 0.7 of cases respectively (p> 0/05). The mean times of getting to the highest sensory block level in lidocaine 5 and bupivacaine 0/5 groups were 11.53 minutes (+/-6.24) and 11.87 minutes ( +/-5.54) respectively after spinal anesthesia (p> 0.05). Anesthetic spreading to C1-C7 and T1-T4 dermatoms in lidocaine 5 group was accomplished in 1.3 and 10 of cases, and it was also reported for the same dermatoms in bupivacaine group 0.7 and 8 of cases respectively (p

Provision of inspiratory humidity in patients connected to ventilator prevents drying and increasing the density of airway secretions, airway obstruction and following complications. Nursing stuff plays an important role at the correct application of ventilator‘s humidifiers. In this study we evaluate the effect of nursing education on the correct application of ventilator‘s humidifiers in intensive care units. This research was done as a randomized double blind study at two stages: At first step, 327 connected ventilators to patient were investigated according to the presence of humidifier, distilled water in the humidifier‘s container, connection tubes, connectors and connection of humidifier system to inspiratory arm. Then nursing education was done for correct application of ventilator‘s humidifiers in intensive care units, without previous information about research proposal. At second step, after the nursing education, all stages similar to first step were repeated and the data were recorded in questionnaire. Data were analyzed by SPSS software, Chi- square and fisher tests. According to analysis of data statically, before and after nursing education: The %91.40 and %82.60 of ventilators had humidifier system, respectively, which the reduction was statically significant (P= 0.001). The %49.80 and % 65.20 of humidifier systems had connectors and connective tubes, which the increase was statically significant (P= 0.00). The %39.10 and %47.80 of humidifiers had distilled water in their containers, respectively, which was statically significant (P= 0.04). Active and connected ventilators to patient that had humidifier system, connective tubes connected to inspiratory arm and humidifier‘s container with distilled water simultaneously were formed %26.60 and %23.50 of ventilators, the difference was not statically significant (P= 0.37). Nursing education for proper and complete usage of humidifiers in patients under ventilators had a few effect that could be caused by: the lack of the supply of humidifier system, the high amount of duties, the personnel shortages, the low motivation of nurses, the lack of personnel attention to the learning and employing their own knowledge and the lack of the knowledge of nurses about the research.

The aim of this study was to determine the prevalence of hydatidosis in Lorestan province during a 10 year period (2005-2014). We surveyed medical records of infected patients with hydatid cyst who had been operated in referral hospitals of Lorestan province, Iran. Several parameters were analyzed including age, gender, place of residency, hospitalization time, and the location of cysts. Cystic Echinococcosis (CE) affected more males 114 (52.52%) than females 84 (47.47%). The age of the patients ranged from 3 to 76 years, and the age group 20– 30 years (27%) was the most affected. Cysts were localized in liver and lung in 62.63% and 37.37% of cases respectively and unusual cyst locations in kidneys, brain, pelvic area, spleen and spine was not observed. The average hospitalization time was 7 days. The distribution of residence in patients showed 124 (62.63%) of them to have urban origin and 74 (37.37%) were rural residents. Significant relationships were found between gender and cyst location, and place of residency and cyst location (p

Background : Pilonidal disease incidence is increasing ) 26 people per 100,000 (aged 18 - 40 years old. As a matter of fact, this age range is the most optimal time of anindividual social and economic activities. Thus it was decided to assess the prognosis in patients with pilonidal sinus surgery in Shohada hospital of Khorramabad during 2005-2012. Materials and Methods: In a retrospective cohort study by referring to the archives of Khorramabad Shohada hospital and receiving records and contact numbers of the patients undergoing pilonidal sinus surgery( primary closure versus open delayed closure), variables such as age, gender, personal history of previous illnesses, surgical procedure used, complications after treatment and etc. were statistically analyzed and evaluated. Results: It was reported that all patients treated with primary closure surgery method, compared to the open healing ( 50% of patients ) had deep satisfaction (P= 04.0 in female patients and P= 002.0 in male patients). The most common complication of the primary closure, was bleeding from the position. While in patients with open healing, most patients complain of long term pain of surgery position, as well as local infection, bleeding and recurrent pilonidal sinus, respectively (P = 024.0 in female patients and P= 000.0 in male patients). Conclusion: According to the results the most common complications after pilonidal disease, were related to open delayed closure procedure, which keeps the patients to be aloof from social and economic activities.

Background: With advances in medical sciences and control of infectious diseases cancers in human societies are increasingly attract attention Cancers of upper gastrointestinal is among the most important cancers which has a high incidence in many countries. Materials and Methods: This cross-sectinal study was conducted on 73 patients with dysphagia, epigastric pain, and weight loss in the short term that the pathologic study confirmed the presence of cancer in the upper gastrointestinal tract since Aprill 2005 to April 2006. Results : The incidence of upper gastrointestinal cancer in men was twice as high as that of women.The upper GI cancers were most prevalent in the seventh and eight decade of life. In this study, patients were given hot tea, but did not mention the consumption of fatty foods. Conclusion : Esophageal and gastric cancers are very frequent in Lorestan province and also Iran. It seems that the role of nutritional factors may be more important than smoking .

Background and Objectives: Pilonidal sinus is a disease in the sacrococcygeal region diagnosed through the purulent discharges of the above-said region. Although the exact pathology and etiology of those suffering from pilonidal is not clear yet, the presence of hair seemingly plays a major role in the process of infection and the granulation tissue. Several techniques have been identified for pilonidal surgery. These techniques primarily fall within two categories: Primary repair and Lay open. One of the setbacks of the primary repair method is the creation of a dead area under the wound which can result in blood accumulation and seroma. To solve the problem of removing the dead space, there are two solutions. The first method utilizes a close suction drain, when the wound discharges are over, the drain is removed. The second technique is called Tie-over where different layers of the wound are pushed close to one another and the dead region vanishes. The present research seeks to compare Tie-over and Closed Suction Drainage methods through random clinical trial in order to introduce the superior technique for faster recovery and reduction of the economic load on the patient. Methods: Some 64 patients suffering from sacral plonidal sinus aging from 15 to 50 in Shohadaye Ashayer Hospital of Khoram Abad in 2013 were selected for the research based on the inclusion criteria. The demographic information of them was collected through questionnaires. The patients were randomly divided into two groups undergoing (A) Tiover and (B) Closed Suction Drainage surgeries. Other information such as return to normal activity and total recovery time was also completed through the questionnaire. SPSS software was used to conduct statistical analysis. Results: The results of the statistical analysis showed that the two groups were similar to one another in terms of age, gender, marital status, job, and literacy. A significant difference was observed only between the level of satisfaction (P-value = 0.035) in groups A and B concerning the factors studied after the operation. The post-operation recurrence of pilonidal sinus among those who smoked cigarettes and had undergone Closed Suction Drainage was significantly greater than the non-smokers (P-value=0.011). As of the group undergoing Tie-over surgery, the difference between the patients’ satisfaction in terms of their age was statistically significant and the highest level of satisfaction was observed among those aging 25 to 34 (90%) (P-value=0.023). Conclusion: In sacrococcygeal pilonidal cyst surgery, no difference was observed except for the difference in the level of satisfaction. More satisfaction was observed using the Tiover method.

Several methods are used to evaluate the thyroid nodules. The aim of this study was to determine the sensitivity, specificity, false positive and negative rates, positive predictive value (PPV), and negative predictive value (NPV) of touch imprint, crush preparation, and fine-needle aspiration (FNA) methods. This cross-sectional study was done in Shohada-ye Ashayer University Hospital in Khorramabad. All the patients who underwent thyroid surgery due to thyroid nodules in this hospital between March and September 2011 were evaluated. The thyroid nodules of all the patients were evaluated by touch imprint, crush preparation, FNA, and permanent pathology methods. Finally, the results of the first three methods were compared with the result of permanent pathology method. The mean age of 104 patients who underwent thyroid surgery was 42.6 ± 11.9 years old. Based on permanent pathology, touch imprint, crush preparation, and FNA methods, 15.3, 6.25, 6.25, and 4.4 % of thyroid nodules were malignant, respectively. Sensitivity, specificity, false positive rate, false negative rate, PPV, and NPV of FNA biopsy were 62.5, 100, 0, 37.5, 100, and 95.3 %, respectively. Also, sensitivity, specificity, false positive rate, false negative rate, PPV, and NPV of touch imprint and crush preparation were equal and were 80, 100, 0, 20, 100, and 96.7 %, respectively. Using touch imprint and crush preparation in evaluation of thyroid nodules for rapid evaluation of these nodules in operating rooms seems to be logical, and it can prevent further surgeries.

Background: Chest wall mesenchymal hamartoma (CWH) is a distinct and extremely rare tumor-like lesion of the thorax. It usually presents in the neonatal period or in infancy. The common presentation is in the form of a visible chest wall mass with or without respiratory distress. Case presentation: A 42-year-old man with a history of chest wall trauma since 5 years ago was admitted with a swelling of the anterior of the chest wall and during this period has grown slowly. Physical examination showed a left anterior chest wall deformity. Chest radiographs and chest CT showed a left anterolateral chest wall mass involving the fourth and fifth ribs. Thoracotomy was performed. The tumor and involved ribs were resected with a 5cm safe margin. The histopathologic examination showed hamartoma. The patient has been fallowed up since 60 month ago, and has not had any complaints in this time. Result: Despite the rarity of chest wall hematoma, this side effect must always be taken into consideration while studying the chest wall injuries especially in the case of trauma history due to other differential diagnosis and her side effects such as respiratory problems. Conclusion: Although rare, this condition ought to be kept in mind while dealing with hamartoma Chest wall following trauma in order to avoid its complications such as respiratory problems. Surgical excision is usually curative in combination with conservative therapy if possible.

Background: Primary schwannoma of trachea and bronchus is very rare and can cause the same signs and symptoms as asthma, including airway-obstruction. Case Report: We introduce a 17 years-old girl with left bronchus schwannoma who was under treatment with the primary diagnosis of asthma and allergy. Bronchoscope intervention showed a pedicular tumor in left bronchus which protruded from the orifice of bronchus during hale and inhale leading to more than %80 lumen obstruction of airway. Discussion: The patient underwent surgical treatment of tumor resection and bronchoplasty along with long survival. Following this operation, all signs and symptoms were resolved. Therefore we should be aware that tumors, even this rare one should be considered as a differential diagnosis in patients suffering from airway obstruction, especially when children and young adults don response to usual treatments.