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We decided to evaluate the effect of treatment of diabetic foot ulcers in improving heart function by strain echocardiography than conventional transthoracic echocardiography. This prospective cross-sectional study included patients with diabetic foot ulcer (DFU). Conventional and two-dimensional strain echocardiography performed before and after three months diabetic foot treatment. Then, we compared the echocardiographic parameters including left ventricular ejection fraction (LV-EF), left ventricular global longitudinal strain (LV-GLS). Multivariate and univariate logistic regression analysis were performed to find which variable was mainly associated with LV-GLS changes. 62 patients with DFU were conducted. After echocardiography, all patients underwent surgical or non-surgical treatments. Three months after the treatment, LV-EF was not significantly different with its' primary values (P = 0.250), but LV-GLS became significantly different (P

Background: The liver is the most common organ of the body that is at risk of getting affected by hydatid cyst (75%). All lobes of the liver can be involved with the formation of hydatid cyst, but the right lobe is more involved than the left lobe. The rate of involvement of liver dome and segments 7 and 8 of the right lobe has not been reported so far, but the best treatment for liver hydatid cyst has been found to be surgery. Materials and Methods: In this study, 240 patients with liver hydatid cyst underwent surgery from 2005 to 2017. In this retrospective study, the variables of gender, age, number of liver cysts, involvement of lobe and segments, simultaneous involvement of liver and lung, laparotomy, thoracotomy, the number of patients referred due to the lack of finding cysts in laparotomy, and surgical complications were analyzed. Results: The results showed that the majority of patients were males with age ranging from 8 to 68 years. Right lobe involvement was observed in most of the patients. About 62 patients showed involvement of liver dome and segments 7 and 8. Therefore, 62 patients underwent thoracotomy according to the criteria introduced and the rest of the patients (n = 178) underwent laparotomy. The results showed that there was a potential for capitonnage in 46 patients in thoracotomy. The pain score was 4–5 according to the VAS criterion. The rate of using analgesic drug did not show significant difference between the two methods. Conclusion: During the manipulation, cysts might be ruptured and give rise to complications such as spread of the disease, shock, and anaphylaxis, which may be followed by legal complaints. Therefore, in order to perform the surgery successfully, a new method along with computed tomography (CT) scan has been introduced in this study, which can be very helpful.

Thymolipomas are rare benign tumors, constituting one of the differential diagnoses of an anterior mediastinal mass. These tumors may have an indolent, asymptomatic course, often achieving massive dimensions before presentation. When it is symptomatic, respiratory symptoms predominate. We report a case of thymolipoma in a 30-year-old male complaining of heaviness and constricting type of chest pain and neck swelling of 1-year duration. Computed tomography scan finding revealed a space-occupying lesion in the anterior mediastinum and extend to the right side of the mediastinum, neck, and left hemithorax. A sono-guided core needle biopsy was carried out which identified an atypical cell and was suspicious to liposarcoma. The tumor was completely excised through “posterolateral thoracotomy.” Postoperative histopathological examination confirmed the diagnosis of thymolipoma. This is the second case we have reported from our institution.

Introduction: The elective abdominal aortic aneurysm repair leads to a remarkable decrease in the rupture of aneurysm and an increase in the life expectancy among patients. Aim: To study the mortality rate and complications of the open elective abdominal aortic aneurysm repair. Materials and Methods: This descriptive cross-sectional retrospective study was carried out on all patients who had undergone open elective abdominal aortic aneurysm repair in Rasht Hospitals, Iran, from March 2007 to March 2011. The background variables, i.e., preoperative, intraoperative, and postoperative results, as well as relevant variables including mortality and complications were recorded on a checklist. The data collected were analysed using SPSS 21.0 through univariate and multivariate analyses. Results: From the total of 61 patients, 11 (18%) were female and 50 (82%) of them were male. Nine patients (14.8%) died within 30 days from the surgery, and five patients (8.2%) suffered complications: Acute renal failure (three individuals) and sepsis (two individuals). In the univariate analysis, the Blood Urea Nitrogen (BUN) level of over 25 mg/dL (p=0.028) and the serum creatinine level of over 1.2 mg/dL (p=0.047) had a significant correlation with postoperative mortality. Additionally, the intensive care unit stay (p=0.019) and the duration of the mechanical ventilation (p=0.021) were significantly correlated with the postoperative complication occurrence. Conclusion: The BUN level of over 25 mg/dL and the serum creatinine level exceeding 1.2 mg/dL were the predictors of mortality, and the intensive care unit stay and the duration of the mechanical ventilation were the predictors of the postoperative complication occurrence after the open elective abdominal aortic aneurysm repair.

Background/Aim: We report the results of a short- and long-segment cardiomyotomy for relief of the symptoms of achalasia. Patients and Methods: From 1997 to 2009, 41 patients (22 men, 19 women) with achalasia underwent cardiomyotomy. Patients were divided into 2 groups [short-segment group (SSG) and long-segment group (LSG)]. SSG include 22 patients with laparotomy and 8-cm short-segment myotomy and Dor fundoplication. LSG includes 19 patients with thoracotomy and 12-cm long-segment myotomy and Belsey partial fundoplication. Results: Median follow up was 48 months (range: 12-70 months). Postoperative dysphagia improved in 20 patients in SSG and in 17 patients in LSG (P < 0.001). Slow emptying sensation improved in 19 patients in SSG and in 16 patients in LSG postoperatively (P < 0.001). Heartburn was present in 2 patients in SSG and 3 patients in LSG postoperatively (P = 0.179). Radiologically, barium stasis decreased significantly from 88% to 25% in SSG and from 85% to 30% in LSG. The lower esophageal sphincter (LES) gradient decreased from 32 to 10 mmHg in SSG and from 34 to 14 mmHg in LSG (P < 0.001). Conclusions: Short-segment cardiomyotomy reduces the LES gradient and relieves obstructive symptoms.

Carbon nanotube (CNT) is considered as a new generation of material possessing superior mechanical, thermal and electrical properties. The applications of CNT, especially in composite materials, i.e. carbon nanotube reinforced polymer have received great attention and interest in recent years. To characterize the influence of CNT on the stress intensity factor of nanocomposites, three fracture modes (opening, shearing and tearing) are considered. The stress intensity factor of nanocomposites is evaluated using a representative volume element (RVE) based on the continuum mechanics and finite element method (FEM). Inter-atomic interactions of CNT are simulated by beam elements in the finite element (FE) model. Non-linear springbased line elements are employed to simulate the van der Waals (vdW) bonds. In all fracture modes, the stress intensity factor was determined for pure matrix and matrix reinforced with single-walled carbon nanotube (SWCNT). Numerical results indicate that the load carrying capacities of the CNTs in a matrix are evident. Addition of CNTs in a matrix can increase the stiffness of the composite. Finally, the results showed that utilizing of SWCNT decreased the stress intensity factor and improved crack resistance.