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Background: Pilonidal sinus disease is a common infectious process that occurs on the natal cleft and sacrococcygeal part. The treatment of pilonidal sinus disease remains challenging and despite the existence of many non-surgical and surgical methods, there is no consensus for the best treatment for this disease. Objective: The goal of this study is to investigate the outcomes of pilonidal sinus surgery by three methods of semi-open, primary repair, and elliptical rotational flap. Methodology : This prospective randomized study was conducted on patients suffering from primary pilonidal sinus. The patients were randomly assigned to one of the three groups based on surgical technique, were followed according to a checklist within the first, second and fourth weeks, as well as third and sixth months after surgery. Follow up was done in terms of recurrence, surgical complications, post-operative pain, and duration of hospitalization. Results: One hundred forty-six patients completed the study, including 21 women and 125 men. The mean age of patients was 26.56 +/- 5 years. There was only one case of recurrence and the rate of post-operative haematoma and infection were not significant between groups, while the rate of itching problem was significantly different (P-value = .001). The highest degree of itching, haematoma and infection were in the semi-open, rotational flap and primary repair group, respectively. The mean duration of pain relief and time of hospitalization were 25.73 +/- 11.36 hours and 4.41 +/- 1.56 days, respectively, which were significantly different between groups. The longest mean duration of pain relief and hospitalization were in primary repair and semi-open group, respectively. Conclusions: Elliptical rotational flap is preferred to the other two methods due to less pain, lower recurrence rate after surgery and early return of patients to the economic cycle.

Intentional drug poisoning is the most common method of suicide in the population. Self-inflicted injuries are usually limited to parts of the body that are easily accessible with one's hand, such as the neck, thorax, or upper extremities. Penetrating aortic trauma has a high mortality rate, and open surgery is frequently required.We report a 19-year-old man who stabbed himself in the anterior abdomen with a kitchen knife after ingesting numerous benzodiazepine tablets, resulting in a rupture of intra-abdominal viscera, including the abdominal aorta artery.Aortic penetrating injuries have a high mortality rate. The retroperitoneal position of the abdominal aorta and the minor size of the rupture were associated with the formation of very large clots, which were essential in controlling bleeding and hemodynamic abnormalities.In any patient with drug poisoning following committing suicide, in case of acute abdominal symptoms and hemodynamic disturbance, after controlling the level of consciousness, respiratory, and hemodynamic correction of the patient, immediate consultation with the surgical service should be considered.

Background: Hydatidosis is one of the most critical worldwide parasitic zoonotic diseases. The lung is the second most common site of hydatidosis. This study aimed to evaluate the clinical status, diagnosis, treatment, and radiological findings of pulmonary hydatid cyst in patients referred to tertiary lung center. Methods: From April 2014 to July 2019, patients referred to Masih Daneshvari University Medical Center with the impression of alveolar hydatidosis included. Demographic data of 304 patients were collected including clinical symptoms, laboratory studies, radiological findings, location of the lung involvement, and cyst characteristics. Also, surgical procedures, medical treatments, and post-operative complications were recorded. Results: Pulmonary hydatidosis was confirmed for 234 patients. 55% of patients were males with the mean age of 45.1±16.6 years. The most common symptoms were cough (59.8%), dyspnea (31.1%), and hemoptysis (26%). Left lung, right lung, and bilateral involvement were reported in 40.1%, 55.1%, and 4.8% of cases, respectively. Cyst perforation (39.8%) was the most common intra-operative finding. Surgical interventions included thoracotomy, rigid bronchoscopy, cyst aspiration, and enucleation. The liver was the most concomitant organ involved due to pulmonary hydatidosis (16.6%). The most common postoperative complication was atelectasis, with the rate of 35.7%. 52.2% of patients were discharged within 10 days after surgery. No mortality was reported. Conclusion: Sometimes atypical findings in different imaging modalities make the hydatid cyst diagnosis challenging. Although lobe involvement more than 50% has the indication for lobectomy, we conserved lobes with about 70% involvement in our institution, and patients had no postoperative complications.