Pakistan Journal of Medical and Health Sciences, Jun 30, 2021
Ten to 25 % of all diabetic patients will develop a lower limb ulcer in their lifetime. Ankle-bra... more Ten to 25 % of all diabetic patients will develop a lower limb ulcer in their lifetime. Ankle-brachial index is not accurate in diabetic patients .The resting systolic toe pressure (TP) may be a measure of small arterial function within the periphery. Objective: The purpose of this article is to consider the effect of below-knee angioplasty on systolic toe pressure changes in diabetic patients with critical limb ischemia. Methods/Materials: In this prospective study 114 patients, were included who satisfied the inclusion criteria: patients with critical limb ischemia in the form of tissue loss(ulcer or gangrene) or rest pain, presence of below-knee vessel lesion, and absence of proximal vessels lesion or stenosis. We evaluated the effect of angioplasty on toe pressure of diabetic patients and compared them to non-diabetics. Results: Among 114 patients, 78(68/4%) were men and 36(31/6%) were women. Diabetic patients were 96(84/2%) and non-diabetics were 18 (15.8%). In Paired T-Test analysis we compared toe pressure values of each patient before and after angioplasty and it was a significant difference in both Diabetic and non-diabetic groups.(0.00 and 0.008 respectively). The mean of systolic toe pressure before angioplasty had no difference between the 2 groups (PValue: 0.13). The mean of toe pressure in non-diabetic patients was 42±31.9 and in diabetics was 25.6 and after angioplasty, the mean of toe pressure raised 44.3 in non-diabetics and 19.4 in diabetics. Conclusions: Systolic toe pressure is a valuable tool to evaluate and predict angioplasty effect on below-knee ulcers especially in diabetic patients. Keywords: Below knee Angioplasty, Systolic toe pressure, Diabetes
Introduction: The majority of adult diaphragmatic herniation s is due to a chronic hiatal hernia ... more Introduction: The majority of adult diaphragmatic herniation s is due to a chronic hiatal hernia or caused by a diaphragmatic herniation. Compared to other different forms of congenital herniation s, Morgagni herniation s are relatively rare. Here we introduce a case of a 73-year-old woman diagnosed with Morgagni Herniation and the choice of treatment used for the patient.
Asian Cardiovascular and Thoracic Annals, Apr 2, 2014
Glomus tumors of the trachea are rare and benign, but most become symptomatic, so they need inter... more Glomus tumors of the trachea are rare and benign, but most become symptomatic, so they need intervention. A 21-year-old man was evaluated due to cough and hemoptysis. Computed tomography and bronchoscopy showed a polypoid mass above the carina. The tumor was removed completely by rigid bronchoscopy. The pathologic diagnosis was glomus tumor. After one year, because of recurrence of the tumor at the same site, the patient underwent reoperation, and resection and anastomosis of trachea through a right posterolateral thoracotomy was performed.
In this case report, we described a 74-year-old female patient with major complaint of respirator... more In this case report, we described a 74-year-old female patient with major complaint of respiratory problemsdyspnea after meal. Chest X-ray of the patient revealed a  gianttype IV hiatal hernia. Preoperative evaluations of the patient included esophagoscopy, esophageal manometry, barium swallow, and CT-scan. Repair of the hernia was performed using a dual mesh on the diaphragm and partial anterior fundoplication (Dor fundoplication). After a six-month follow-up, the overall condition of the patient  is satisfactory,  exceptmild intermittent dysphagia due to esophageal dysmotility.
Introduction:Mediastinum contains different vital structures that are located in the anterior and... more Introduction:Mediastinum contains different vital structures that are located in the anterior and middle or posterior compartments. Various types of mediastinal masses or tumors can be seen in the mediastinum. Materials and Methods:This case series study was performed on 95 patients who had referred to Mashhad University of Medical Sciences between 1990 and 2010 were reviewed. The Inclusion criteria were as follows: Having primary mediastinal masses; Exact tissue pathology; Having received suitable treatment as well as having completed a 3-year follow-up after surgery; The major variables were age, sex, clinical symptoms, mass location, diagnostic procedures, imaging studies, tissue pathology, postoperative complications, mortality and a long-term survival. The patients were followed up for 3 years after the surgery. Results:Ninety-five patients enrolled in the study with M/F=51/44 and the mean age of 35.4+16.52 years. Moreover, anterior mediastinum was the compartment mostly involv...
Herein, we present the case of a 45-year-old woman with pulsion and midesophageal diverticula, wh... more Herein, we present the case of a 45-year-old woman with pulsion and midesophageal diverticula, who had complaints of dysphagia and regurgitation. Diagnosis was confirmed by endoscopy and barium swallow. The patient underwent right posterolateral thoracotomy with excision of diverticula and repair of the muscular layer along the site of diverticula. Five days following the operation, barium swallow with the passage of the contrast material through distal esophagus showed no diverticula. After five months, the patient remained asymptomatic.
Hydatid cyst is a parasitic disease that is endemic in Mediterranean areas, South America, North ... more Hydatid cyst is a parasitic disease that is endemic in Mediterranean areas, South America, North Africa, Australia, and Iran. Although the liver and lung are the most common involved organs, but the other organs in human body also can be involved by hydatid cyst. Chest wall involvement by hydatid cyst is a rare condition, which may be misdiagnosed as chest wall tumor in the endemic areas. Herein, we presented a case of primary chest wall hydatid cyst mimicking chest wall tumor.
A 25-year-old man was admitted in hospital due to right side hemopneumothorax secondary to car ac... more A 25-year-old man was admitted in hospital due to right side hemopneumothorax secondary to car accident. A chest tube was inserted. During the hospitalization days, chest CT scan revealed a 3cmx3 cm oval-shaped density located in the right upper lobe. Since he was in a good general condition, he was discharged from hospital after removal of chest tube and a follow-up chest CT-scan was recommended. In the chest CT scan that was performed 3 months later (Figure 1), the oval-shaped density was increased in size. There was no endobronchial lesion in bronchoscopic evaluation. Surgery was recommended He was underwent thoracotomy and the lesion was resected (Figure 2). It was post-traumatic pulmonary hematoma (Figure 3).
Journal of Gorgan University of Medical Sciences, 2020
Background and Objective: Trauma is the most important causes of lossing effective life in human ... more Background and Objective: Trauma is the most important causes of lossing effective life in human comunities, and it is the second leading cause of death in Iran. This study was done to determine the pattern of penetrating injuries and intrathoracic organ damage in Gorgan, north of Iran. Methods: In this descriptive study, data of 107 patients with penetrating injuries whom referred to 5th Azar hospital in Gorgan-Iran during 2016-17 were collected. Age, gender, job, type, location and cause of injury were recorded for eacgh subject. Results: The mean age of patients was 26.13 years. The most frequent job was related to unemployed group (39.25%). The most freqent causes of trauma were quarrel with 78.5%. The most divice were knife with 66.35%. Lung was the most injured organ with 11.21%. The least damage was to the large vessels with one case (0.93%). The two patients died due to heart and subclavin vessels injuries. Conclusion: This study showed that injury due to knife was the most ...
Introduction: Esophageal cancer is among the most common malignancies. Hospital mortality in the ... more Introduction: Esophageal cancer is among the most common malignancies. Hospital mortality in the past decade reduced; but its morbidity is still high. Pulmonary complications are the most common complications after esophageal resection. In this study we examined the effect of steroids administration during surgery to reduce postoperative morbidity with a focus on respiratory complications.Material and Methods: Patients with esophageal cancer who underwent transhiatal esophagectomy, randomly divided into two groups to thirty patients: The intervention group (received 125mg methylprednisolone sodium succinate). After surgery, patients admitted in the ICU for a day. Oral feeding initiated on day 7th and patients discharged home on the day 8th or 9th.Postoperative complications included anastomotic fistula, wound infection in the neck and abdomen and pulmonary complications. We analyzed pulmonary complications included pneumonia, Acute lung injury (ALI) or acute respiratory distress syn...
A 25 year-old Construction worker underwent neck laceration following penetrating neck trauma in ... more A 25 year-old Construction worker underwent neck laceration following penetrating neck trauma in a falling incident. The 3rd tracheal ring was injured which was initially repaired and the patient was discharged in good general condition. (Figure 1 shows the patient’s neck view after discharge from hospital).Two months later the patient was again admitted due to provocative coughing and a metal foreign body was detected in his right main bronchus. (Figure 2 shows CXR of the patient and Figure 3 demonstrates CT scan of the same patient). Finally the patient underwent rigid bronchoscopy to remove the foreign body. (Figure 4 shows the foreign body after rigid bronchoscopy).
Asia Oceania Journal of Nuclear Medicine and Biology, 2019
Objective(s): Lymph node metastases are the most significant prognostic factor in localized non-s... more Objective(s): Lymph node metastases are the most significant prognostic factor in localized non-small cell lung cancer (NSCLC). Identification of the first nodal drainage site (sentinel node) may improve detection of metastatic nodes. Extended surgeries, such as lobectomy or pneumonectomy with lymph node dissection, are among the therapeutic options of higher acceptability. Sentinel node biopsy can be an alternative approach to less invasive surgeries. The current study was conducted to evaluate the accuracy of sentinel node mapping in patients with NSCLC using an intraoperative radiotracer techniques. Methods: This prospective study was conducted on 21 patients with biopsy-proven NSCLC who were candidates for sentinel node mapping during 2012-2014. All patients underwent thoracoabdominal computed tomography, based on which they had no lymph node involvement. Immediately after thoracotomy and before mobilizing the tumor, peritumoral injection of 2mCi/0.4 mL Tc-99m- phytate was perfo...
Figure 1. AP chest and neck X-ray of the patient Figure 3. Picture of the foreign body(bone) afte... more Figure 1. AP chest and neck X-ray of the patient Figure 3. Picture of the foreign body(bone) after extracting by rigid esophagoscopy Figure 2. Lateral neck X-ray of the patient Figure 4. Barium swallow 2 days after removal of foreign body
Pakistan Journal of Medical and Health Sciences, Jun 30, 2021
Ten to 25 % of all diabetic patients will develop a lower limb ulcer in their lifetime. Ankle-bra... more Ten to 25 % of all diabetic patients will develop a lower limb ulcer in their lifetime. Ankle-brachial index is not accurate in diabetic patients .The resting systolic toe pressure (TP) may be a measure of small arterial function within the periphery. Objective: The purpose of this article is to consider the effect of below-knee angioplasty on systolic toe pressure changes in diabetic patients with critical limb ischemia. Methods/Materials: In this prospective study 114 patients, were included who satisfied the inclusion criteria: patients with critical limb ischemia in the form of tissue loss(ulcer or gangrene) or rest pain, presence of below-knee vessel lesion, and absence of proximal vessels lesion or stenosis. We evaluated the effect of angioplasty on toe pressure of diabetic patients and compared them to non-diabetics. Results: Among 114 patients, 78(68/4%) were men and 36(31/6%) were women. Diabetic patients were 96(84/2%) and non-diabetics were 18 (15.8%). In Paired T-Test analysis we compared toe pressure values of each patient before and after angioplasty and it was a significant difference in both Diabetic and non-diabetic groups.(0.00 and 0.008 respectively). The mean of systolic toe pressure before angioplasty had no difference between the 2 groups (PValue: 0.13). The mean of toe pressure in non-diabetic patients was 42±31.9 and in diabetics was 25.6 and after angioplasty, the mean of toe pressure raised 44.3 in non-diabetics and 19.4 in diabetics. Conclusions: Systolic toe pressure is a valuable tool to evaluate and predict angioplasty effect on below-knee ulcers especially in diabetic patients. Keywords: Below knee Angioplasty, Systolic toe pressure, Diabetes
Introduction: The majority of adult diaphragmatic herniation s is due to a chronic hiatal hernia ... more Introduction: The majority of adult diaphragmatic herniation s is due to a chronic hiatal hernia or caused by a diaphragmatic herniation. Compared to other different forms of congenital herniation s, Morgagni herniation s are relatively rare. Here we introduce a case of a 73-year-old woman diagnosed with Morgagni Herniation and the choice of treatment used for the patient.
Asian Cardiovascular and Thoracic Annals, Apr 2, 2014
Glomus tumors of the trachea are rare and benign, but most become symptomatic, so they need inter... more Glomus tumors of the trachea are rare and benign, but most become symptomatic, so they need intervention. A 21-year-old man was evaluated due to cough and hemoptysis. Computed tomography and bronchoscopy showed a polypoid mass above the carina. The tumor was removed completely by rigid bronchoscopy. The pathologic diagnosis was glomus tumor. After one year, because of recurrence of the tumor at the same site, the patient underwent reoperation, and resection and anastomosis of trachea through a right posterolateral thoracotomy was performed.
In this case report, we described a 74-year-old female patient with major complaint of respirator... more In this case report, we described a 74-year-old female patient with major complaint of respiratory problemsdyspnea after meal. Chest X-ray of the patient revealed a  gianttype IV hiatal hernia. Preoperative evaluations of the patient included esophagoscopy, esophageal manometry, barium swallow, and CT-scan. Repair of the hernia was performed using a dual mesh on the diaphragm and partial anterior fundoplication (Dor fundoplication). After a six-month follow-up, the overall condition of the patient  is satisfactory,  exceptmild intermittent dysphagia due to esophageal dysmotility.
Introduction:Mediastinum contains different vital structures that are located in the anterior and... more Introduction:Mediastinum contains different vital structures that are located in the anterior and middle or posterior compartments. Various types of mediastinal masses or tumors can be seen in the mediastinum. Materials and Methods:This case series study was performed on 95 patients who had referred to Mashhad University of Medical Sciences between 1990 and 2010 were reviewed. The Inclusion criteria were as follows: Having primary mediastinal masses; Exact tissue pathology; Having received suitable treatment as well as having completed a 3-year follow-up after surgery; The major variables were age, sex, clinical symptoms, mass location, diagnostic procedures, imaging studies, tissue pathology, postoperative complications, mortality and a long-term survival. The patients were followed up for 3 years after the surgery. Results:Ninety-five patients enrolled in the study with M/F=51/44 and the mean age of 35.4+16.52 years. Moreover, anterior mediastinum was the compartment mostly involv...
Herein, we present the case of a 45-year-old woman with pulsion and midesophageal diverticula, wh... more Herein, we present the case of a 45-year-old woman with pulsion and midesophageal diverticula, who had complaints of dysphagia and regurgitation. Diagnosis was confirmed by endoscopy and barium swallow. The patient underwent right posterolateral thoracotomy with excision of diverticula and repair of the muscular layer along the site of diverticula. Five days following the operation, barium swallow with the passage of the contrast material through distal esophagus showed no diverticula. After five months, the patient remained asymptomatic.
Hydatid cyst is a parasitic disease that is endemic in Mediterranean areas, South America, North ... more Hydatid cyst is a parasitic disease that is endemic in Mediterranean areas, South America, North Africa, Australia, and Iran. Although the liver and lung are the most common involved organs, but the other organs in human body also can be involved by hydatid cyst. Chest wall involvement by hydatid cyst is a rare condition, which may be misdiagnosed as chest wall tumor in the endemic areas. Herein, we presented a case of primary chest wall hydatid cyst mimicking chest wall tumor.
A 25-year-old man was admitted in hospital due to right side hemopneumothorax secondary to car ac... more A 25-year-old man was admitted in hospital due to right side hemopneumothorax secondary to car accident. A chest tube was inserted. During the hospitalization days, chest CT scan revealed a 3cmx3 cm oval-shaped density located in the right upper lobe. Since he was in a good general condition, he was discharged from hospital after removal of chest tube and a follow-up chest CT-scan was recommended. In the chest CT scan that was performed 3 months later (Figure 1), the oval-shaped density was increased in size. There was no endobronchial lesion in bronchoscopic evaluation. Surgery was recommended He was underwent thoracotomy and the lesion was resected (Figure 2). It was post-traumatic pulmonary hematoma (Figure 3).
Journal of Gorgan University of Medical Sciences, 2020
Background and Objective: Trauma is the most important causes of lossing effective life in human ... more Background and Objective: Trauma is the most important causes of lossing effective life in human comunities, and it is the second leading cause of death in Iran. This study was done to determine the pattern of penetrating injuries and intrathoracic organ damage in Gorgan, north of Iran. Methods: In this descriptive study, data of 107 patients with penetrating injuries whom referred to 5th Azar hospital in Gorgan-Iran during 2016-17 were collected. Age, gender, job, type, location and cause of injury were recorded for eacgh subject. Results: The mean age of patients was 26.13 years. The most frequent job was related to unemployed group (39.25%). The most freqent causes of trauma were quarrel with 78.5%. The most divice were knife with 66.35%. Lung was the most injured organ with 11.21%. The least damage was to the large vessels with one case (0.93%). The two patients died due to heart and subclavin vessels injuries. Conclusion: This study showed that injury due to knife was the most ...
Introduction: Esophageal cancer is among the most common malignancies. Hospital mortality in the ... more Introduction: Esophageal cancer is among the most common malignancies. Hospital mortality in the past decade reduced; but its morbidity is still high. Pulmonary complications are the most common complications after esophageal resection. In this study we examined the effect of steroids administration during surgery to reduce postoperative morbidity with a focus on respiratory complications.Material and Methods: Patients with esophageal cancer who underwent transhiatal esophagectomy, randomly divided into two groups to thirty patients: The intervention group (received 125mg methylprednisolone sodium succinate). After surgery, patients admitted in the ICU for a day. Oral feeding initiated on day 7th and patients discharged home on the day 8th or 9th.Postoperative complications included anastomotic fistula, wound infection in the neck and abdomen and pulmonary complications. We analyzed pulmonary complications included pneumonia, Acute lung injury (ALI) or acute respiratory distress syn...
A 25 year-old Construction worker underwent neck laceration following penetrating neck trauma in ... more A 25 year-old Construction worker underwent neck laceration following penetrating neck trauma in a falling incident. The 3rd tracheal ring was injured which was initially repaired and the patient was discharged in good general condition. (Figure 1 shows the patient’s neck view after discharge from hospital).Two months later the patient was again admitted due to provocative coughing and a metal foreign body was detected in his right main bronchus. (Figure 2 shows CXR of the patient and Figure 3 demonstrates CT scan of the same patient). Finally the patient underwent rigid bronchoscopy to remove the foreign body. (Figure 4 shows the foreign body after rigid bronchoscopy).
Asia Oceania Journal of Nuclear Medicine and Biology, 2019
Objective(s): Lymph node metastases are the most significant prognostic factor in localized non-s... more Objective(s): Lymph node metastases are the most significant prognostic factor in localized non-small cell lung cancer (NSCLC). Identification of the first nodal drainage site (sentinel node) may improve detection of metastatic nodes. Extended surgeries, such as lobectomy or pneumonectomy with lymph node dissection, are among the therapeutic options of higher acceptability. Sentinel node biopsy can be an alternative approach to less invasive surgeries. The current study was conducted to evaluate the accuracy of sentinel node mapping in patients with NSCLC using an intraoperative radiotracer techniques. Methods: This prospective study was conducted on 21 patients with biopsy-proven NSCLC who were candidates for sentinel node mapping during 2012-2014. All patients underwent thoracoabdominal computed tomography, based on which they had no lymph node involvement. Immediately after thoracotomy and before mobilizing the tumor, peritumoral injection of 2mCi/0.4 mL Tc-99m- phytate was perfo...
Figure 1. AP chest and neck X-ray of the patient Figure 3. Picture of the foreign body(bone) afte... more Figure 1. AP chest and neck X-ray of the patient Figure 3. Picture of the foreign body(bone) after extracting by rigid esophagoscopy Figure 2. Lateral neck X-ray of the patient Figure 4. Barium swallow 2 days after removal of foreign body
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