Letter From the Editor-in-Chief

We are honored to announce that the number of total published original articles will be raised.

Total Gastric Necrosis as a Presentation of Aluminum Phosphide Poisoning: A Case Report

Background: Rice pill poisoning is among the most frequent causes of death among poisoners. Despite advances in the treatment of this poisoning, its mortality rate remains high. The symptoms of Aluminum Phosphide (AlP) poisoning are varied and progressive. One of the essential foundations of diagnosis is based on the history of swallowing the pill by the patient or their companions.Case Report: A 20-year-old woman with generalized abdominal pain and a diagnosis of peritonitis was operated. The operative finding was total gastric necrosis. After the operation, the patient’s husband claimed that she had consumed some rice pills, intending to commit suicide. Despite all efforts, she remained in persistent septic shock and multi-organ failure and passed away after surgery.Conclusion: Total gastric necrosis could be among the lethal complications of rice tablet (AlP) poisoning

Rare presentation of pancreatic schwannoma: a case report

<p>Abstract</p> <p>Introduction</p> <p>Schwannoma is a rare tumor among pancreatic neoplasms. Schwannomas vary in size, and most of them are cystic, mimicking pancreatic cystic lesions. Generally, a definitive diagnosis is made at the time of histological analysis. The mainstay treatment is surgical resection.</p> <p>Case presentation</p> <p>We report an unusual presentation of pancreatic schwannoma with abdominal pain and several episodes of cholangitis in a 54-year-old Caucasian (Iranian) man. The condition was not diagnosed pre-operatively and Whipple's procedure was performed.</p> <p>Conclusion</p> <p>Pancreatic schwannoma is an important clinical entity to include in the differential diagnosis of pancreatic lesions. Pre-operative diagnosis is difficult but computed tomographic findings may be helpful. The tumor may also have atypical and rare presentations, such as cholangitis and weight loss. For benign tumors, simple enucleation is usually adequate, whereas malignant tumors require standard oncological resection.</p

Ultrasound-guided Placement of Permanent Hemodialysis Catheters Compared to the Traditional Blind Method

Background: Central venous hemodialysis catheters are one of the most common vascular accesses for patients suffering from end-stage kidney disease. The application of ultrasound-guided placement of permanent hemodialysis catheters is highly recommended by the new guidelines because of its advantages over the traditional blind methods.Methods: In this prospective study, the samples comprised patients (N=80) referred to a vascular surgery clinic by their nephrologist or elective vascular surgery consultations and asking for the placement of permanent hemodialysis catheters in Imam Hossain Hospital (A referral hospital complex center in, Tehran, Iran) during 2014 to 2015. The patients were randomly divided into two groups (n=40); one of the groups underwent the placement of catheters with the guidance of Doppler ultrasound and the other with the traditional blind method. Then, the data were analyzed by SPSS V. 21 software.Results: There was statistically significant fewer attempts for successful placement (Z= -2.725, P=0.006), less insertion failure (Chi-Square=9.600, P=0.002), fewer failures with the first attempt (Chi-square=9.600, P=0.002), and less total placement time (t=1.379, df=69.549, P=0.172) in the sonography-guided group compared to the blind method. Furthermore, there was no significant difference in venous cannulation time and complications such as pneumothorax, neck hematoma, and carotid puncture between the two groups. Moreover, the patients had significantly greater satisfaction with the sonography-guided method (Z=-4.306, P=0.0001).Conclusion: According to this study, it might be beneficial to use ultrasound as the first method of permanent hemodialysis catheters insertion and patients would be more satisfied with this approach as well. In addition, learning the blind method is recommended to the practitioners because of the possibility of lacking ultrasound in an emergency

Review of Unusual Presentations of COVID-19

The world has faced the coronavirus disease 2019 (COVID-19) pandemic since the H1N1 influenza pandemic in 1918. The symptoms of this disease are spreading rapidly and affect almost all systems of the body. In addition to the common symptoms of the virus, numerous reports of rare symptoms of the virus have also been published. These atypical presentations can result in difficulty in diagnosing the disease. The aim of this work is to summarize “uncommon atypical presentations”, which have not received enough attention in descriptions of the disease presentation to date and the authors specifically discuss the important uncommon atypical presentations of COVID-19

Endovascular treatment of thoracoabdominal aortic aneurysm: a case report

<p>Abstract</p> <p>Introduction</p> <p>Thoracoabdominal aortic aneurysms usually present in elderly patients with serious renal, pulmonary, cerebral, or cardiac comorbidities that pose a great challenge to the attending surgeon. Endovascular techniques for the treatment of thoracoabdominal aneurysms are not yet widely used due to limitations associated with them, such as spinal and visceral ischemia.</p> <p>Case presentation</p> <p>An 87-year-old Caucasian man with a symptomatic Crawford type I thoracoabdominal aortic aneurysm was treated successfully with a long tube stent graft using endovascular techniques and without any complication in follow-up examinations. The stent was placed distal to the left subclavian artery, and proximal to the celiac axis.</p> <p>Conclusion</p> <p>The use of endovascular stents for long segment thoracoabdominal aortic aneurysms needs to undergo clinical investigation to determine whether this procedure decreases morbidity and mortality rates.</p