Presentation of Epicardial and Intrapericardial Hydatid Cysts: A Case Series

Hydatid cyst mainly involves the liver and lung; however, it can rarely involve cardiac tissue. This study describes the presence of hydatid cysts in the heart with considerable disease points in Tehran, Iran. Two cases aged between 25 to 50 years with cardiac hydatid cyst involvement were identified in 2021 in Tehran, Iran. Epicardial hydatid cyst between a left anterior descending coronary artery (LAD) and left obtuse marginal artery (OM) on the left ventricle, and in the second case, intrapericardial cyst attached to the pulmonary trunk with a thin base were identified. The cardial cysts were resected, and the patients recovered without any complications.  Cardiac hydatid cyst is a very rare disease. Rapid diagnosis and surgical and medical care are necessary for treatment

Potentially fatal atrium perforation due to right jugular vein catheterization recognized by venography: A case report

Abstract Central venous catheters are the prevalent path for dialysis. Our case was a 54‐years‐old male with a new case of end‐stage renal disease with a complaint of right jugular hemodialysis catheter dysfunction. In our case, the early dysfunctional catheter should be evaluated with contrast studies to achieve accurate information

Esophageal Atresia: Migration of the gastrostomy tube into the bronchus

A 2-day-old baby boy, 38 weeks gestation, weight 2000 g was brought due to hypersalivation and imperforate anus with gasless abdomen on plain X-ray. He underwent a gastrostomy tube insertion and colostomy. In contrast study of the stomach, on the 5th postoperative day, the dye spilled into the tracheo bronchial tree and the catheter was seen,entering the right main bronchus. The patient underwent right thoracotomy and the presence of fistula and catheter were confirmed. The fistula and distal esophagus were closed and fixed to the prevertebral fascia because of a long gap. He is under follow-up and recieving home care for a later delayed primary anastomosis

Low-level laser therapy: An experimental design for wound management: A case-controlled study in rabbit model

Background: There is a wide array of articles in medical literature for and against the laser effect on wound healing but without discrete effect determination or conclusion. This experimental study aims to evaluate the efficacy of low-level laser therapy on wound healing. Materials and Methods: Thirty-four rabbits were randomly enrolled in two groups after creating a full thickness of 3 × 3 cm wound. The intervention group received low density laser exposure (4 J/cm 2 ) on days 0, 3 and 6 with diode helium-neon low-intensity laser device (wl = 808 nm) and in control group moist wound dressing applied. Finally, wound-healing process was evaluated by both gross and pathological assessment. Results: Fibrin formation was the same in the two groups (P = 0.4) but epithelialisation was much more in laser group (P = 0.02). Wound inflammation of the laser group was smaller than that of the control groups but statistical significance was not shown (P = 0.09). Although more smooth muscle actin was found in the wounds of the laser group but it was not statistically significant (P = 0.3). Wound diameter showed significant decrease in wound area in laser group (P = 0.003). Conclusion: According to our study, it seems that low-level laser therapy accelerates wound healing at least in some phases of healing process. So, we can conclude that our study also shows some hopes for low level laser therapy effect on wound healing at least in animal model

Central Venous Line and Acute Neurological Deficit: A Case Series

Central venous catheter (CVC) insertion is a practical way to assess patients hemodynamic specially in cardiovascular surgery but this relatively simple junior level procedure is not risk free and its common reported complications include; pneumothorax, hydrothorax, hemothorax, local hematoma, cardiac tamponade, vascular injury, thrombosis, embolism, and catheter disruption. Here in this article we are going to present 6 patients with very unusual presentation of CVC complication which was neurological deficit presented by agitation , unconsciousness, disorientation to time and place and  hemiparesis. All patients undergone neurologic consult and brain computed tomography. Final diagnosis was brain ischemic damage and finally we kept them on conservative management; fortunately we did not have any permanent damage

The role of gastrostomy in the staged operation of esophageal atresia

Introduction: The aim of this study is to recommend criteria for selection of patients who benefited from the use of gastrostomy rather than emergency fistula closure during the staged operation of esophageal atresia (EA). Materials and Methods: Between August 2004 and July 2006, 75 cases of EA, were consecutively operated. Nineteen out of 75 (25%) underwent routine gastrostomy because they required a type of staged operation: Group I: Five cases with pure atresia had gastrostomy and esophagostomy; Group II: Six with severe pneumonia and congenital heart disease (Waterson class C) had gastrostomy and conservative management; Group III: Eight with long gap EA (2-4 vertebras); four out of 8 cases underwent primary anastomosis with tension and the other four had delayed primary anastomosis plus primary gastrostomy. Results: GI: Only three cases survived after esophageal substitution; GII: Three out of six cases with severe pneumonia (fistula size: f > 2.5 mm) underwent emergency fistula closure with only one survival, but all (f < 2.5 mm) recovered without complication, GIII: Four patients with long gap and primary anastomosis with tension developed anastomotic leakage; they required gastrostomy following the leakage, except for those with delayed primary anastomosis, and all of them recovered without early complications. Conclusion : All the cases with long gap, although two esophageal ends can be reached with tension, should undergo delayed primary closure with primary gastrostomy. Those were brought with Waterson class C and the fistula size greater than 2.5 mm should undergo emergency fistula closure; however, if fistula size was less than 2.5 mm, it is better to be delayed by primary gastrostomy for stabilization. In this study, we had a better outcome with gastric tube for substitution than colon interposition in infants

A comparative study of partial vs total splenectomy in thalassemia major patients

Background : In this study, we show the advantages of partial splenectomy (PS) over total splenectomy (TS) regarding the chances of overwhelming postsplenectomy sepsis (OPSI). Materials and Methods: From February 1991 to December 1999, 143 cases of β-thalassemia underwent PS. 1/3, 1/4 of the splenic tissue was preserved. One hundred and ten cases were followed for an average of 5 years. None of the patients received vaccination or prophylactic antibiotics. Pre- and postoperative hematological profiles, IgM levels, recurrence of hypersplenism and septic episodes were compared among the data of 60 cases TS; all these cases have been operated in the same hospital. Results: Hematological profile significantly increased and transfusion requirement approximately reduced to three-fold. After 3 years, 22.7% in PS and 13.3% in TS groups required the same amount of preoperative transfusion. After 5 years, these percentages were 27.3 and 18.3%, respectively. Two patients in PS and six in TS group developed signs of sepsis. Conclusion : Vaccination or prophylactic antibiotics are not necessary after PS. The risk of sepsis in PS without antibiotics is less than that in TS with antibiotics, and resplenectomy after PS is not associated with serious complications

Esophageal Atresia: Migration of the gastrostomy tube into the bronchus

A 2-day-old baby boy, 38 weeks gestation, weight 2000 g was brought due to hypersalivation and imperforate anus with gasless abdomen on plain X-ray. He underwent a gastrostomy tube insertion and colostomy. In contrast study of the stomach, on the 5th postoperative day, the dye spilled into the tracheo bronchial tree and the catheter was seen, entering the right main bronchus. The patient underwent right thoracotomy and the presence of fistula and catheter were confirmed. The fistula and distal esophagus were closed and fixed to the prevertebral fascia because of a long gap. He is under follow-up and recieving home care for a later delayed primary anastomosis