Iranian Journal of Surgery
Year:2015 | Volume:23 | Issue:4|Papers Count:15

Human Lung hydatid cyst is a health problem in endemic area. Lung is the second most common organ after liver to be involved by parasite. Human is accidental intermediate host whom is infected by orally take up the primary host egg-containig feces, vegetables and water. Surgery is the treatment of choice but medical therapy is indicated in the case of exclusion from surgery. In this article, lung’s hydatid disease and its treatment are reviewed.

Introduction & Objective: Intractable epilepsy can be catastrophic for the patient as well as his/her caregivers. If a lesion is responsible, potential growth of the mass will be an important source of new concerns. When evacuation is planned, every tool that can help the surgeon to recognize the so called “epileptogenic zone”, and can facilitate safe and total removal of the lesion would be precious. The aim of conducting this study is to evaluate the benefit of using functional MRI (fMRI), tractography, and neuronavigation on achieving total resection, seizure freedom, and decreased neurological complications for the lesions located adjacent or within the eloquent cortex of brain.Materials & Methods: Thirty three patients were enrolled and randomized into two groups: traditional surgery (16 patients) and surgery with fMRI, tractography and neuronavigation (17 patients). Patients were followed. Extent of resection, success of intervention to provide seizure freedom or worthwhile improvement, and neurological complications were assessed, recorded and compared between the two groups.Results: As for demographic and important prognostic factors, no significant difference was found between the two groups. Total and total-plus resections were achieved more in the fMRI group but the difference was not significant (P -value=0.07). No significant difference was observed with regard to permanent neurological complications. However, satisfactory results in reducing or eradicating seizures were significantly more noticed in fMRI group (88.23% versus 68.75% in the traditional surgery group, withP -value=0.04).Conclusions: Concomitant use of presurgical fMRI, tractography, and neuronavigation during the surgical procedure for lesional epilepsy may be helpful for providing better seizure control.

Introduction & Objective: Breast augmentation is the most common aesthetic surgical procedure in the world. Choices of incisions, pocket plane, and implant characteristics, including shape, texture, filler, and volume, constitute the key decisions in surgical planning. There are few data on their impact on the pectoralis major force. Since the function of this muscle is important in daily activities of patients, we design this study to compare the effects of these two approaches on the power of pectoralis major muscle.Materials & Methods: Twenty female patients were included in this clinical trial. Half of them (10 patients) underwent sub glandular breast augmentation and half the other (10 patients) underwent sub-pectoral breast augmentation. The power of pectoralis major muscle were measured before and six weeks after the surgery. The findings were compared, using SPSS software version 16 and the Analysis of Covariance (ANCOVA) statistical test.Results: The analysis revealed that both groups had experienced a reduction in their muscle forces. Investigations also showed that those patients who underwent sub pectoral breast augmentation, suffered from greater decrease in their pectoralis major muscle power (P=0.03).Conclusions: Although the effect of synergistic muscles and short period of this study are a bias, but our study reveals that sub-pectoral prosthesis insertion decreases the pectoralis major power, relation to the other cases.

Introduction & Objective: In Cryptorchidism, testis is arrested in its normal path of descent. The importance of cryptorchidism is in its complications, such as: inguinal hernia, infertility, cancer, torsion of the spermatic cord and psychological disorders. The irreparable nature of some of these complications, show the necessity of more attention to the treatment of cryptorchidism. The aim of this study is to evaluate the effects of high dose of HCG (Human Chorionic Gonadotropin) on Cryptorchidism treatment and the reduction of the necessity of surgical intervention in boys between 1-3 years of age.Materials & Methods: Our study included 70 cryptorchidic boys, between 1-3 years of age. Patients were divided into two groups (A and B). One group received 1500 IU of high dose of HCG three times weekly for 3 weeks. The second group also received placebo, three times weekly for 3 weeks. One month after the last injection, patients were evaluated with physical examination and ultra-sonography. The effect of HCG on testicular descent and size was examined. Finally, patients who were not treated underwent surgery. Finally, the data were analyzed by SPSS software, using descriptive statistical tests, chi-square test, t test, and logistic regression.Results: A positive correlation was found between the rate of success and the testicular position. There was no relation between the HCG response and gestational age and the age at which treatment was initiated. Response to HCG treatment of cryptorchidism (Testicular descent and testicular size) was 80% (P<0.001). The overall success of HCG treatment of cryptorchidism was 37% (P<0.001). The highest success was for bilateral prescrotal testes.Conclusions: Based on the findings of present study, HCG is effective in descension and enlargement of testis, so confirmation of this matter require complementary studies with larger sample size.

Introduction & Objective: Hydrogel dressings, including those with features, are suitable for use in wound coatings, especially burn wounds. Aloe vera and chitosan, are natural abundant compositions in nature, which can be used in the preparation of hydrogels. The aim of this study was to evaluate the effect of hydrogel, composed of chitosan and aloe vera, in healing burns of half thickness of the chitosan hydrogel in rats and it’s comparison with the local effects of aloe vera alone and chitosan alone.Materials & Methods: In this animal study 28 male rats were randomly divided into 4 groups. After producing half-thickness burns of the size 8 × 5 cm on the back of all the rats, the first group of used the combination of aloe vera and chitosan the second group used aloe vera alone and third group used chitosan alone and the control group was without dressing. On days 7th and 14th all rats had digital photography, as well as random a number of rats in each group were cultured and biopsied. The wounds were examined and evaluated by the Image J. software partitioning samples were taken for histopathology.Results: The findings of this study showed that the average level of hydrogel wound dressing in combination with chitosan and aloe vera at the end of the fourteenth day was 1.62 ± 1.07 cm2 and chitosan hydrogel dressing was 6.91 ± 0.57 cm2, and in the third group was 7.63 ± 1.58 cm2, and it was 7.98 ± 1.01 cm2 in the control group. According to our results, there is a significant difference about the rate of wound healing in group of hybrid hydrogel of chitosan and aloe vera compared to the other groups (P<0.001).Conclusions: Hybrid hydrogel of Chitosan and aloe vera to quickly restore the proper, recommended as a suitable dressing.

Introduction & Objective: Each population or nation has its own cephalometric criteria. Cephalometric analysis is applied in maxillofacial, rhinoplastic, orthognatic operations and bioengineering. The aim of this study is to define the cephalometric criteria used for in Qazvin’s adolescents with normal occlusion, on the basis of Natural Head position (NHP).Materials & Methods: This cross-sectional descriptive study was conducted on 117 males and 117 females with normal occlusion. Their mean age was 16.6±1.1 years and 16.2±1.1 years respectively, which had no history of orthodontic treatment or facial trauma. The mean value and standard deviation of cephalometric parameters were calculated, using SPSS software. The resulting norms for male and female groups were compared, with standard norms using a student T-test.Results: Most of midface and total face height variables were greater in males than females and all of midface and lower face horizontal variables were significantly greater in males, except for the case of SNO, and most of parameters were different from Stiener Norms.Conclusions: Qazvin adolescents have distinct cephalometric features and it is important to consider ethnic and racial variations and sex differences. Skeletally, males have greater vertical and horizontal lengths.

Introduction & Objective: Gastric cancer is the fourth most common and the second most deadly cancer worldwide. Surgical removal is the only therapeutic option for gastric cancer, which may be through endoscopic mucosectomy or through the more limited laparoscopic methods or open surgery. This study aimed to evaluate the different dimensions of quality of life in patients with gastric cancer who underwent gastrectomy surgery.Materials & Methods: In this study, the data collection tool was the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire and a self-generated questionnaire for recording the pathological and clinical findings of the patients. The quality of life questionnaire was completed using face to face interviews of the researcher with the patients (before the surgery and 6 months after it) and with the control group. Clinico-pathological questionnaire too, was completed through the information gathered from the patient's records. Finally, the data were analyzed by SPSS software, using descriptive statistical tests, chi-square test and non-parametrical tests in some items.Results: Totally the quality of life in 54 patients with gastric cancer (before the gastrectomy and 6 months after it) was compared with the control group. The control group was consisted of patient's kin or entourage. The analysis showed that physical function (P=0.001), emotional function (P<0.001), social function (P<0.001), cognitive function (P<0.001), and role function (P=0.013) of patients, 6 months after the gastrectomy surgery had statistically significant improvement. But in the control group, there was no statistically significant improvement in different dimensions of quality of life 6 months later. Furthermore, symptoms such as Fatigue, nausea, pain, loss of appetite, sleep disorders, constipation, and dyspnea were better 6 months after the surgery.Conclusions: Given the high prevalence of gastric cancer and its different social and psychological damages, it seems necessary to conduct various studies in order to achieve the proper ways for improving the quality of life in patients with gastric cancer and all other cancers; studies that can evaluate and monitor the effectiveness of different therapeutic methods in terms of improving the quality of life and achieving a complete remission in patients.

Introduction & Objective: Gastrointestinal perforation is one of the most important causes of emergent surgeries in surgery wards. Demography of peptic ulcer perforation has changed considerably since the first reported case, especially in relation to the age and gender of patients. In the present study, we tried to study predisposing factors in perforation of peptic ulcer, in Hospital of Imam Reza (AS), during 2006 to 2011.Materials & Methods: This study was a cross - sectional study, which involves the case studies and complete the registration forms of the patients with peptic ulcer perforation, who underwent surgery at the Medical Center of Imam Reza (AS), during the years 2006 to 2011 were admitted, was done. This form includes variables such as age, use of NSAIDS, alcohol, cigarettes, consumption of PPI and H.Pylori infection. Data were analyzed with the SPSS software.Results: In this study, 97 (88.2%) were male and 13 (11.8%) were female. The mean age was 47.44 years old with 18.05 SD. The history of smoking was positive in 74 patients (67.3%) and 57 patients (44%) were drugs addicts. Comorbidities were present in 31cases.25 of the patients had a history of NSAID use and 30 cases (27.3%) had a history of previous perforation of gastric ulcer. Also, all patients with H. pylori history, which were 19% of the study population all had a history of PPI and 24 patients had a history of occasional alcohol consumption. The average length of stay per patient was 7 days.Conclusions: The most common place of perforation was around the pyloric stomach. The risk factors of the condition were: age, the use of drugs, cigarettes, alcohol, nonsteroidal anti-inflammatory drugs (NSAIDs), helicobacter pylori infection and associated diseases.

Primary paratesticular tumours are rare, and only account for 7% to 10% of all intrascrotal tumours. In adults, more than 75% of these lesions arise from the spermatic cord, and 20% being leiomyosarcoma. In this study we present a rare case of primary paratesticular leiomyosarcoma in a 68 years-old man presenting with a right painless scrotal mass. Scrotal ultrasound showed a solid heterogenic lesion. Tumor markers such as alpha-fetoprotein, lactate dehydrogenase and beta-human chorionic gonadotropin were normal. A right radical orchidectomy confirmed Primary paratrsticular leiomyosarcoma.