A Rare Case of Acquired Segmental Megacolon with Unknown Cause in a Young Woman

Abstract: Acquired Megacolon is a rare disease that usually presents in elderly people and there have been only few reported cases in literature. In this article we report a 24-year-old woman who had referred with chronic intermittent epigastric pain from 4-5 years ago and also chronic constipation and distension of upper abdominal part. Clinical examinations and imaging studies (chest x-ray, barium enema) showed dilatation of colon with unknown border. She underwent laparatomy surgery with primary diagnosis of partial colon obstruction. Several biopsies were taken from dilated and collapsed parts. Microscopic findings showed destruction of ganglion cells in dilated areas and normal ganglion cells in collapsed parts. At the second operation dilated parts were resected and end to end anastomosis of collapsed parts were done. The patient was discharged in good general condition. About 77 days after operation, the patient was examined again in order to following up. She was in a very good physical condition and had a weight gain about 20 pounds. Keywords: Megacolon, Intestinal obstructio

A Case Report of Gastrointestinal Bleeding Due to Gastric Lipoma

Abstract: Benign Gastric tumors are rare and generally account for less than 10% of all stomach tumors. Gastric lipoma is a rare tumor that constitutes approximately 3% of all benign tumors of the stomach and mainly is seen as a submucosal mass. Most gastric lipoma are asymptomatic and are found accidentally. Occasionally they can cause symptoms such as gastrointestinal bleeding, obstruction, abdominal pain and intussuception. CT scan and endoscopy are helpful in diagnosis. The main modality of treatment is surgery. Diagnosis is confirmed by histology. In this article, a patient with weakness, fatigue, and melena complaints is presented. On gastric endoscopy a yellowish submucosal mass was seen in antrum. Abdominal CT scan disclosed a mass with fat density resembling lipoma. The patient underwent surgery and diagnosis of lipoma was confirmed by histology. Although gastric lipoma is rare, it should be considered in the assessment and differential diagnosis of hemorrhagic submucosal masses in the stomach. Keywords: Lipoma, Gastrointestinal bleedin

Evaluation of Injuries Caused by Penetrating Chest Traumas in Patients Referred to the Emergency Room

The aim of the study was to determine the frequency of different injuries caused by penetrating chest traumas, and also the cause and type of trauma and its accompanying injuries. This is a cross-sectional descriptive study, carried out on all patients referred to the emergency room of Shahid Bahonar Hospital, Kerman, from March 2000 to September 2008, due to penetrating chest trauma. The required information including age, sex, cause of trauma, type and site of injury, and accompanying injury was obtained and used to fill out a questionnaire and then was analyzed. 828 patients were included in the study; most of them were in the age range of 20-29. Of the patients, 97.6 % were males. The most frequent cause of trauma was stabbing, and the most frequent injuries following the trauma were pneumothorax and hemothorax. Orthopedic trauma was the most frequent accompanying injury. The most commonly used diagnostic method was plain chest radiography. In 93 % of the patients, the chest tube was placed and thoracotomy was performed for 97 % of the patients. Shahid Bahonar Hospital is a referral Trauma Centre and treats large number of chest trauma patients. Most patients need only chest tube placement as a definitive treatment

Comparison of the Frequency of Recurrent Laryngeal Nerve Injury with and without Exploration of the Nerve in Thyroidectomy

Abstract: Background & Aims: Surgeons are not willing to participate in thyroid surgeries due to dangerous, although rare, complications of the procedure. Post thyroidectomy complications are divided in early and late onset; hypocalcemia, bleeding, thyroid storm and recurrent laryngeal nerve (RLN) injury are the most important ones. This study was performed to compare the frequency of recurrent laryngeal nerve injury with and without nerve exploration in the thyroidectomy operation. Methods: In this Cohort study, we evaluated 566 cases underwent thyroidectomy during about 6 years (2005-2011) in two centers, Bahonar and Afzalipour hospitals, in Kerman, Iran. Results: A total of 566 patients, 124 men (21.9%) and 442 women (78.1%) with the mean age of 40.26 years and the mean hospitalization period of 3.35 days were evaluated. 382 patients (67.5%) underwent total or subtotal thyroidectomy and 184 (32.5%) underwent lobectomy and isthmectomy. 124 patients (21.9%) had malignant and 442 (78.1%) had benign lesions. The most common found malignancy was papillary thyroid carcinoma (PTC), where as the most found benign lesion was multinodular guiter (MNG). Recurrent laryngeal nerve exploration was done for 337 patients (59/5%). Totally, 6 cases (1.1%) showed Recurrent laryngeal nerve injury (1 in exploration and 5 in non exploration group) from which, 4 had permanent hoarseness and 2 had permanent dysphonia. Also, malignancy and radical neck dissection had significant effect on nerve injury but re-operation and unilateral or bilateral surgery had not. Conclusion: Recurrent laryngeal nerve identification and exploration decreased the incidence of nerve injury significantly. We believe that recurrent laryngeal nerve identification and exploration during thyroidectomy is the best procedure to decrease the risk of nerve injury. Keywords: Recurrent laryngeal nerve injury, Thyroidectomy, Hoarsness, Dysphony, Recurrent laryngeal nerve exploratio

Electrochemical Detection of Hydrazine by Carbon Paste Electrode Modified with Ferrocene Derivatives, Ionic Liquid, and CoS2-Carbon Nanotube Nanocomposite

The electrocatalytic performance of carbon paste electrode (CPE) modified with ferrocene-derivative (ethyl2-(4-ferrocenyl1,2,3triazol-1-yl)acetate), ionic liquid (n-hexyl-3-methylimidazolium hexafluorophosphate), and CoS2-carbon nanotube nanocomposite (EFTA/IL/CoS2-CNT/CPE) was investigated for the electrocatalytic detection of hydrazine. CoS2-CNT nanocomposite was characterized by field emission scanning electron microscopy, X-ray powder diffraction, and transmission electron microscopy. According to the results of cyclic voltammetry, the EFTA/IL/CoS2-CNT-integrated CPE has been accompanied by greater catalytic activities for hydrazine oxidation compared to the other electrodes in phosphate buffer solution at a pH 7.0 as a result of the synergistic impact of fused ferrocene-derivative, IL, and nanocomposite. The sensor responded linearly with increasing concentration of hydrazine from 0.03 to 500.0 μM with a higher sensitivity (0.073 μA μM-1) and lower limit of detection (LOD, 0.015 μM). Furthermore, reasonable reproducibility, lengthy stability, and excellent selectivity were also attained for the proposed sensor. Finally, EFTA/IL/CoS2-CNT/CPE was applied for the detection of hydrazine in water samples, and good recoveries varied from 96.7 to 103.0%. Â

Diversity of Phlebotomine sand flies (Diptera: Psychodidae) in mountainous and plain areas of an endemic focus of anthroponotic cutaneous leishmaniasis in Iran

Objective: To determine the diversity of sand flies in different biotopes of mountainous and plain areas of Bam County as the most infected focus of anthroponotic cutaneous leishmaniasis in southeast Iran, and synanthropic index of Phlebotomus sergenti Parrot, and Phlebotomus papatasi Scopoli as the main vectors of cutaneous leishmaniasis in Iran. Methods: Sand flies were captured once a month using sticky traps in domestic, peri-domestic, agricultural, and sylvatic biotopes in the plain and mountainous areas. Alpha diversity indices, including richness, evenness, Shannon-Wiener; beta diversity indices (Jaccard's and Sorensen's similarity indices) and synanthropic index were calculated. Results: A total of 2 664 specimens of 9 sand fly species were collected from mountainous (47) and plain (53) areas. Species richness, species evenness, and Shannon-Wiener indices were obtained as 9, 0.637, and 1.399, respectively in the mountainous area. Phlebotomus sergenti and Phlebotomus papatasi were constant species with the synanthropic index of-18.463 and-29.412, respectively. In addition, species richness, species evenness, and Shannon-Wiener indices were 4, 0.690, and 0.956, respectively in the plain area. Phlebotomus sergenti and Phlebotomus papatasi were dominant species with the synanthropic index of +9.695 and +36.207, respectively. Similarity indices were low among different biotopes of plain and mountainous areas. Conclusions: A basic knowledge about the diversity of sand flies in various biotopes is essential to design sound control programs. Biodiversity and synanthropic indices of sand flies are different in plain and mountainous areas due to the difference in biotic and abiotic factors between the two areas. © 2020 Asian Pacific Journal of Tropical Biomedicine Produced by Wolters Kluwer Medknow. All rights reserved

Evaluation of different attractive traps for capturing sand flies (diptera: Psychodidae) in an endemic area of leishmaniasis, Southeast of Iran

Background: The attraction of phlebotomine sand flies to plant and animal hosts is due to the produced chemical compounds, affecting the olfactory receptors of the insects. Therefore, novel and effective methods, such as Attractive Toxic Sugar Baits (ATSB) and Attractive Toxic Baits (ATB), are based on the effective materials that attract sand flies toward the host. The present study was designed to identify the attractive materials in plants and animals for using in ATSB and ATB. Methods: This cross-sectional study was carried out in July 2018 on endemic areas of leishmaniasis in Iran. Different baits, including mango, nectarine, grape, banana, melon and watermelon, defibrinated blood of cattle, sheep, goat and chicken, urine of cattle, sheep, goat and ultimately, simple and complex chemicals, such as CO2, 1-octanol, lactic acid and human sweat were placed inside the traps, and the rate of the sand flies attraction to these materials was studied. Furthermore, data were analyzed using the Kruskal-Wallis test and Mann Whitney U test. Results: There was a significant difference in the sand flies attraction between the traps containing watermelon, urine of cattle, and sheep, and chemicals such as CO2 and human sweat and the control trap (p< 0.05). Conclusion: This study showed that watermelon and CO2 are the potential candidates for using in ATSB and ATB, respectively. © 2020 Tehran University of Medical Sciences. All rights reserved

A long-lasting emerging epidemic of anthroponotic cutaneous leishmaniasis in southeastern Iran: population movement and peri-urban settlements as a major risk factor

Background: Epidemics of cutaneous leishmaniasis (CL) are occurring more frequently and spreading faster and farther than before in many areas of the world. The present study aimed to assess a long-lasting emerging epidemic (2005�2019) of 5532 cases with anthroponotic CL (ACL) in peri-urban areas of Kerman city in southeastern Iran. Methods: This descriptive-analytical study was carried out for 15 years in Kerman province, southeastern Iran. The data were passively obtained through the health surveillance system and the Kerman Leishmaniasis Research Center. Every subject was diagnosed using direct smear microscopy. The representative causative agent was further examined by ITS1-PCR, PCR-RFLP, 7SL RNA gene sequencing and phylogenetic analyses. For each subject, a case report form designating demographic and clinical data was recorded. Results: A different pattern of ACL incidence was found in peri-urban areas compared to that in the city of Kerman. The incidence rate of ACL cases has significantly increased (P < 0.001) from 2005 to 2016 in new settlements with a gradual decline after that. The overall average risk of contracting the disease was 7.6 times higher in peri-urban areas compared to Kerman city, an old endemic focus. All isolates consisting of six variants were confirmed to be Leishmania tropica. The overall pattern of the ACL infection indicates that the etiological agent of ACL is propagated and transmitted by the bite of female Phlebotomus sergenti sandflies from person to person from dissimilar clones as reflected by the complexity of the migrants� backgrounds in the province. Conclusions: The movement of populations and establishment of new settlements in peri-urban areas close to endemic areas are major risk factors for and are directly linked to CL. The underlying factors of this emerging ACL epidemic caused by L. tropica were disasters and droughts, among others. A robust commitment to a multilateral approach is crucial to make improvements in this area. This will require decisive coordinated actions through all governmental factions and non-governmental organizations. Furthermore, active and passive case detection strategies, early diagnosis, and effective treatment could help control the disease. Figure not available: see fulltext.. © 2021, The Author(s)