[Huge biliary stag horn]

Small or large, single or multiple common bile duct [CBD] stone occur in 6-12% of patients suffering from gallstone. Incidence of CBD stone increases with age. 20-25% of patients who suffer of gallstone associated with CBD stone are above 60 years old. In westerns, CBD stones originate from gallbladder that pass from cystic duct to CBD, these named secondary stones. Primary stones construct in intra or extra hepatic biliary ducts. We present such a rare case, 75 years old lady with an unusual casting large CBD stone with 40mm diameter and 150mm long which extends toward hepatic branches proximally. We named it biliary staghorn due to shape similarity to renal staghorns. Patient had colici abdominal pain in right upper quaderant since several years ago. She have any complications as collangitis or pancreatitis. Diagnosis made by ultrasound and patient operated on for retrieval of stone by choledocotomy. Choledojejunostomy Reux-en-Y for biliary drainage

[Relationship between fish consumption and decreased breast cancer risk]

Numerous animals models have shown the inhibitory effects of fish oil on tumor growth, due to its long - chain omega - 3 fatty acids. The association between fish intake and breast cancer was investigated in this case - control study. This retrospective study involved 197 women with breast cancer and 197 healthy subjects as control. Data were collected by questionnaires concerning demographic data, reproductive as well as breast cancer - related risk factors and a food frequency questionnaire. Information about fish intake one year prior to the disease onset was collected through the questionnaire. Qualitative variables and age were tested through chi square and Mann- Whitney statistical tests, respectively. Logistic regression analysis was used for final data analysis. The mean and standard deviation of age in case and control groups were 46.03 +/- 9.03 and 43.47 +/- 7.9 years, respectively. According to the final data analysis, shrimp [p=0.01] and tuna fish [p=0.002] intake were significantly influential in decreasing breast cancer risk. There was no significant association between breast cancer risk and total fish intake, its preparation and source [cultivated vs. marine]. There was no association between total fish intake, its source and/or preparation method and breast cancer. However, different fish species, shrimp intake, and use of conserved fish were important in reducing breast cancer risk

Study of a new method for inguinal hernia repair

Inguinal hernia accounts for about 80% of all hernias and are the most common surgical procedure done in infants. There are different methods for repairing of inguinal hernia such as tissue repair; rate of recurrence by this method is 1-3%. The purpose of this study was to introduce new method for this surgery and assessing recurrence and complications. This was a semi clinical trial. 174 patients were considered after five years. [During 1998-2002]. In this method after removing of hernia's sac, the floor of inguinal canal was torn in two layers continuously. One of them was torn from cooper ligament to fascia transversalis and the other one was torn from inguinal ligament to conjoint tendon and finally the fascia of external muscle was torn on spermatic cord. The patients were assessed by a questionnaire composed of two sections; one about the site of inguinal hernia and age of patients and the other was composed of questions about complication and recurrence of surgery. Data was compared to other conventional tissue repair using Z test. The mean age of patients were 28-48 years, 164[94%] were males and 10[5/7%] were females, 59[34%] of patients had left inguinal hernia [56 male and 3 female], 92[52%] had right inguinal hernia [88 male and 4 female] and 23[13%] had bilateral inguinal hernia [20 male and 3 female]. Two patients [1/1%] had recurrence two years after surgery and no complication were seen after 5 years. There were no significant difference between methods of surgery [1/1% recurrence] and other conventional tissue repair methods [1-3% recurrence]. More long evaluation is required to recommend this fast and simple method for routine repair of inguinal hernias

Prevalence of malignancy in thyroid nodules in referral patients to Imam Khomeini Hospital during 1370-1379

Thyroid nodule is a risk factor in thyroid carcinoma. So proper awareness, evaluation and appropriate management of these nodules can result in early diagnosis and treatment of thyroid cancer which can lead to better prognosis. In this study we evaluated 100 patients with thyroid nodules who referred to Imam khomeini hospital of Ahvaz during 1370-79. Findings showed that 18% of the subjects were diagnosed as thyroid cancer after operation and 89% were those who had solitary and cold nodule. It is believed that medical suppression therapy is a treatment of choice in these patients but we believe this can induce delay in diagnosis and appropriate treatment. So, lobectomy and isthmectomy appear to be the management of choice in thyroid nodules especially in solitary and cold nodule in males