Background: The most important step in treating a pilonidal sinus is eradication by surgical excision. Over the years, various surgical techniques have been reported for wound closure, yet their management still poses a challenge. The current study compares the results of two different methods of wound management: secondary wound healing versus the Z-plasty surgical technique. Material and method: The current clinical trial recruited 84 uncomplicated pilonidal sinus patients who were to undergo complete surgical excision of the pilonidal sinus. For wound healing, the 84 subjects were equally divided into two groups of 42 patients each. One group was selected for Z-plasty surgical wound closure and the other for the secondary healing mechanism. Outcomes measured consisted of demographic data, length of operation, complications, severity of pain, number of dressings, recurrence, and complete healing time. Result: Age or sex distribution and the median BMI (kg/m²) did not significantly differ between the two groups. The length of the operation for Z-plasty subjects was significantly longer (P <0.0001). The median number of dressing changes for secondary wound healing patients was 38.69, which was significantly higher than the 4.95 dressing changes for the Z-plasty group. The total time recorded for complete wound healing was 21.61±4.27 days in the Z-plasty group and 41.23±24.28 days for secondary wound healing subjects, which was statistically significant. Twenty-four hours postoperation, patients in the secondary wound healing group had significantly more pain, and the Visual Analogue Scale scores of the Z-plasty and secondary wound healing groups were 3.42±0.76 and 6.09±1.2, respectively. Concerning the recurrence rate, there were no significant differences between the two groups. SPSS version 22 performed the analyses, and the independent t-test compared the continuous variables. A P value less than 0.05 was considered statistically significant. Conclusion: Z-plasty is a safe and effective procedure in terms of wound complications and recurrence rate. This method is also cost-effective and better received by patients.

Limited studies investigate bariatric surgery’s role in improving UI status among Asians, specifically Middle Eastern Asian women. The aim of this study is to investigate the effect of bariatric surgery on the three most prevalent urine incontinence (UI).We also reviewed the current literature exploring the studies performed in Asian countries. A total of 77 women out of 200 who had UI and indications for bariatric surgery completed demographic information and the questionnaire (QUID) prior to surgery and 6 months after the surgery. For statistical analysis, the Mann–Whitney U test, Wilcoxon test, and Friedman test were utilized. We also performed a literature review with the aim of investigating studies performed in Asian countries. Among the initial analysis of 200 participants, 50.5

Preservation rhinoplasty focuses on maintaining the physiological anatomy of the nose. Preserving the physiological angles between the upper and lower cartilages is important for minimizing complications and achieving satisfactory outcomes in rhinoplasty procedures. In this study, 42 candidates (23 females and 19 males) undergoing elective primary open rhinoplasty in Shiraz between 2020 and 2021 were included prospectively in a single-center hospital. The mean patient`s age was 26.2 ± 5.2, and they were between 18 and 40 years old. The angle of divergence, resting angle, and angle between the border of the upper lateral cartilage (ULC) and the lower lateral cartilage (LLC) were measured before and after cephalic resection. The study found a significant increase in the border angle of ULC and LLC, and the angle of divergence, the resting angle following cephalic resection. The mean angle of divergence increased from 78.0952 ± 29.15711 to 80.1426 ± 26.73590 degrees. The resting angle increased from 115.9762 ± 17.99931 to 119.038 ± 25.38592 degrees. The border angle of ULC and LLC increased from 39.8571 ± 14.38592 to 40.3095 ± 14.10844 degrees. The level of cephalic resection measured 5.4524 ± 1.29167. These findings indicate that cephalic resection of LLC has a significant impact on the anatomical nasal angles. Surgeons should consider the amount of cephalic resection and its effects on these angles to optimize patient satisfaction in terms of both function and aesthetics. Level of Evidence: Level IV, Therapeutic Study.

Background: Diabetic foot is one of the long-term microvascular complications of diabetes mellitus (DM). The prevention of foot ulcers is the most effective way to reduce severe morbidity and mortality in patients with diabetes. Appropriate glycemic control is one of the most important preventive measures for diabetic foot ulcers. Glycosylated hemoglobin (HbA1C) is representative of long-term blood glucose levels over the prior three months. The present study evaluated the relationship between HbA1C levels and the development of diabetic foot ulcers. Methods:The present study was an analytical case-control study conducted in Ali-ibn-Abitaleb Hospital in Zahedan, Iran, in 2022. 130 patients comprising 65 DM patients with diabetic foot ulcers and 65 DM patients without foot ulcers were included in this study. Demographic and laboratory information was collected by the researcher using a checklist. The data were analyzed using SPSS software. Results: The average age of the control and case groups was 64.1 and 62.6 years, respectively. The results showed a significant relationship between the age of 60-70 years and the onset of diabetic foot ulcers. There was also a significant relationship between the female gender and the occurrence of diabetic foot. No significant relationship was observed between the duration of DM and the onset of diabetic foot. The results showed that 87.7% of the people in the control group had no previous history of diabetic foot. However, 76.9% of the people in the case group had a prior history of diabetic foot. There was a significant relationship between the previous history of the diabetic foot and its recurrence in diabetic patients. Regarding the serum level of HbA1C, 78.5% and 12.3% of patients in the case group had moderate (7-10%) and poor control (10-13%), respectively. 43.1%, 50.7%, and 6.2% of people in the control group had good, moderate, and poor control and in the multivariable model, only the previous history remained in the model, which showed that the probability of infection in people with a previous history is almost 24 times higher than in people without a previous history. Conclusion: The results indicate that age, female gender, history of diabetic foot, and high serum level of HbA1c had a significant relationship with diabetic foot. Since the serum level of HbA1c is an important indicator of long-term blood sugar control, it can possibly be used as a reliable factor to predict diabetic foot complications

Along with the advances in medical science, surgical methods have also undergone many advances. Today, with the advancement of technology in all fields, including medicine, robots have entered medical science. These robots have many uses as well as advantages and disadvantages that they enjoy in Iran and other countries. In this study, it was addressed. This study is a review of robotic surgery methods in Iran and other countries in the form of a review study. This study is a conceptual review. The steps performed are 1- Designing a research question, 2- Searching and extracting research-related studies, 3- Selecting related studies, 4- Tabulating and summarizing information and data, and 5- Reporting results. The results showed that robotic surgery in operations such as brain, kidney, open heart, liver, eye, laparoscopy, dental surgery, coronary artery surgery, hysterectomy, lymphadenectomy, general surgery, obstetrics, head and neck, shelf Chest, urology, endoscopy, colonoscopy, ear, nose, and throat are used and have advantages such as three-dimensional vision, flexible rotation of the instrument, reduction of surgeon hand vibration with vibration filter, ease of surgery and the ability to create the required patterns It reduces the volume of blood lost during surgery, the length of stay in the hospital, the amount of pain, and subsequently the number of analgesic doses consumed in the postoperative ward. Disadvantages include the relative increase in operating time, the high cost of robots, and the physician's lack of sensory perception of the patient's environment.

Considering the importance of lymphoma and its prevalence in communities as well as its relationship with genetic factors (P53 & MDM2) as well as contradictory results about the possible role of deletion/insertion of polymorphisms in different types of cancer. The aim of this study was to investigate the deletion/insertion of 40 bp of mdm2 polymorphism and 16-bp of p53 polymorphism in patients with lymphoma. In this case-control study, 152 non-Hodgkin's lymphoma patients and 155 healthy individuals were selected by convenience sampling method. MDM2 and P53 polymorphisms were examined by PCR. SPSS V22 software was used to interpret the results. The results of the study showed that rs3730485 species was associated with the risk of lymphoma. The Ins / Del and Del / Del genotypes reduce the risk of lymphoma compared to the Ins / Ins genotype (OR = 0.41,95% CI = 0.25-0.65 P <0.001 and OR = 0.33.95% CI = 0.12). 0.96, P = 0.035 In relation to Ins / Del + Del / Del and Ins / Del, the results also showed that they reduce the risk of lymphoma (OR = 0.40,95% CI = 0.25-0.63, P <0.001). Results indicated that Ins / Del, Del / Del, Ins / Del + Del / Del and D alleles genotypes had a statistically significant relationship with lymphoma risk. Due to the fact that the OR genotypes of this site are less than one step away, it is a protective factor for lymphoma, so that these alleles and the mentioned genotype reduce the risk of lymphoma.

Introduction: The aim of this study is evaluation of chin deformities and their role in rhinoplasty cosmetic surgery outcomes via photogrammetry of chin. Materials and Methods: The study is a cross sectional one. All photos of rhinoplasty surgery candidates of three hospitals (Amir Aalam, Imam Khomeini and Razi of Tehran) which were taken in standard lateral position via SLR cameras were assessed through Adobe Photoshop CS, in order to determine four different aesthetic measurements. Except for excluded photos due to our excluding criteria or technical problems, all photographs were evaluated carefully. Results: 144 photos of patients were enrolled. The oldness of patients ranges between below 20 up to above; 65.99 patients were female (68.8%) and 45 were male. 73 patients (50.7%) had an abnormal silver condition. Moreover 9 patients (6.3%) with abnormal nasomental, 124 patients with abnormal status of Gonzalez-Ulloa (93.8%), 63 patients (43.8%) with unusual status of Ricketts’ E line/upper and 49 patients (34%) with abnormal Ricketts’ E line/lower status can be demonstrated. Discussion: Performing a photogrammetric study for candidates of cosmetic rhinoplasty also a chin examination as a mandatory preoperative assessment seems to be essential. Due to the lack of studies in this field, more studies are necessary.

BACKGROUND:Today, the role of microRNAs in the pathogenesis of breast cancer has been established. Genetic mutations play a significant role in determining the risk factors of cancer. The polymorphism of these two genes can alter their expression. This study has been performed to investigate the relationship between polymorphisms of rs6715345 of miR-375 gene and rs4939827 of the SMAD7 gene and development of breast cancer in a population in southeastern Iran. METHODS:This case-control study was performed on the blood sample of 205 patients with breast cancer and 225 healthy individuals for investigating the rs34917480 and rs4939827 polymorphisms using the PCR-RFLP method. The data were analyzed by t-test, χ2, and logistic regression. The SPSS v18.0 used for data analysis. RESULTS:The findings of this study indicated that the risk of developing breast cancer does not have a significant relationship with rs6715345 polymorphism of miR-375 gene (p=0.1). However, the rs4939827 polymorphism of the SMAD7 gene was significantly linked to the risk of developing breast cancer in the southeastern population in Iran (p=0.01). CONCLUSION:The results suggest that the rs4939827 polymorphism of the SMAD7 gene can lead to an increased risk of incidence of breast cancer in the southeastern population in Iran..

Background: Historically, burn injuries have been accompanied by bad prognosis. With the advances in recovering fluids and the early excision of burn scars, the survival rate has enhanced for severe burn patients. Objectives: The study aimed to analyze the epidemiology of burn injuries in Zahedan, Eastern Iran. Patients and Methods: This retrospective study examined 2173 burn patients for eight years. The research data were extracted from patients’ files and analyzed by SPSS 22 using the chi square test, t test and ANOVA. Results: In sum, out of 2173 files, 2115 files were analyzed. About two-thirds (71%) of burns were due to flame, one-fifth (21.2%) to boiling water, and 8% to other means. There was a significant relationship between patients’ age, gender, burn percentage, burn degree, burn cause, burn occurrence season, hospitalization duration, and addiction or non-addiction status with rate of death (P < 0.001). Conclusions: In this region of Iran, burn is influenced by families’ culture, economy, urban service level, workplace, home heating devices, type of people’s clothing, and awareness. The statistical analysis of the existing data completely indicated the epidemiology of burns in Eastern Iran.

Background: Zinc (Zn) and Selenium (Se) are trace minerals that have high anti-cancer and chemopreventive properties. Objectives: This study aimed at evaluating the serum levels of both elements in women with breast cancer (BC) compared with control group and the correlation of them with risk factors of BC. Methods: In a case-control study, 142 women with BC and 158 healthy controls, aged 19 to 88 years, were selected. Both groups did not use any type of supplement 3 months before participation in the study; there was no history of chronic kidney or liver disease or malabsorption disorders among the participants and body mass index was between 18.5 and 30 based on Quetelet index. The Se by graphite furnace and Zn by flame were atomized and the amount of each of 2 elements was measured and recorded by the Absorption device. Results: The mean Zn was 689.57 +/- 146.13 mg/dL in the patient group and 874.85 +/- 150.53 mg/dL in the control group (P < 0.001). Also, the mean Se was 101.24 +/- 17.27 mg/dL in the patient group and 115.36 +/- 13.31 mg/dL in the control group (P < 0.001). There was a significant difference between Se level with stage in patients; therefore, the Se level was lower in metastatic stage compared with 2 other stages (P = 0.028). Conclusions: Decreasing the serum levels of Se and Zn may be the risk factors for BC. It seems that adding micronutrients of Zn and Se in patients with low serum levels may reduce the risk of BC.

OBJECTIVETo determine the economic burden of road traffic accidents (RTAs) in patients admitted to a single center in south eastern Iran.METHODSThis cross-sectional study was conducted in Amir-Al-Momenin hospital of Zabol affiliated with Zabol University of Medical Sciences during a 12-month period from April 2012 to April 2013. All the RTAs patients who were admitted to our emergency department were included. The direct expenses of hospital care were recorded according to their medical charts and the accountant registration information. Data are presented according to different RTAs characteristics.RESULTSOverall 1155 patients were included in the current study with mean age of 36.7 ± 5.14 years among whom there were 673(58.3%) men and 482 (41.7%) women. The annual incidence of RTAs were calculated to be 288 per 100,000 population. The RTAs economic burden in our center was 589,448.49 USD which accounted for 10.4% of total hospital expenses during the study period. The money spend on RTAs in our center was 130 times more than gross national income per capita. Cost of each patient in road traffic was 15 times more than cost of an average patient of the hospital in other sections.CONCLUSIONWith considerable high ratio of accidents in Zabol, proper intervention is needed for controlling and preventing RTAs in order to decrease its injuries, impact and the associated economic burden.

Background: Combination chemotherapy is accepted as a high efficacy treatment for gastric cancer, whereas choice of standard treatment is unclear. Multiple chemotherapeutic regimens have been used to achieve higher efficacy and lower toxicity. This study was designed to evaluate the treatment results of advanced gastric cancer with Capecitabine and Oxaliplatin regimen. Subjects and Methods: All cases with documented gastric adenocarcinoma and advanced disease were candidates for receiving Xelox regimen (Capecitabine - 750 mg/m2/twice daily/ 1-14 days and Oxaliplatin 125 mg/m2 in 1st day). Results: Twenty five cases with advanced gastric cancer entered in study while 24 cases continued treatment protocol and were evaluated. Mean age was 59.5 ± 12.1 years (range: 20-75), male and female cases were 66.7% and 33.3%, respectively. All cases received at least four cycles of Xelox regimen. Overall response rate was 74.99% with 29.16% complete response. Overall survival rate was 13 ± 0.53 months and DFS (disease-free survival) was 6 ± 1.09 months. Extremities neuropathy (62.5%), headache (45.8%) and muscle cramps (29.2%) were the most common complains. Haematological changes were rare and 16.7% of cases had mild cytopenia. Treatment related death was not observed. Conclusion: Xelox regimen is a safe and highly effective first line treatment for gastric cancer; however, considering it as first line therapy needs larger studies.

Background: Fourniers gangrene caused by synergic aerobic and anaerobic organism is a life threatening disorder. Methods: The medical records of 8 among 839 patients admitted to imam ali general hospital Zahedan university of Medical Sciences with fourniers gangrene during the 10 months period between 2012 and 2013 were reviewed. Results: The most common etiology and presentation were abscess and perianal pain respectively. Mixed bacterial flora was common finding in patient. Single debridement was carried out in 2 patients and repeated procedure was needed in 6. Conclusion: This disease is characterized with high mortality of up to 75% but in our study the rate was 37.5%. In other studies diabetes mellitus was found to be the common condition related to fourniers gangrene but in our study the common etiology was perianal abscess. Fourniers gangrene should be rule out in any patient with perianal pain and flulike, swelling skin.