Background: Primary actinomycosis of the breast is a rare disease which may present as sinus tract or with mass-like features mimicking malignancy. Clinical presentation makes it difficult to distinguish primary actinomycosis from mastitis and inflammatory carcinoma. Case Report: A 48-year-old woman presented with a mass in the left breast of 2 months duration. Physical examination was significant for a non-tender mass in the left breast. Histopathologic examination of the excisional biopsy of the mass showed granulomatous inflammation with grains of Actinomyces israelii. Conclusions: Actinomycosis of the breast usually presents as a recurrent abscess with fistulas. It may sometimes present as a breast lump, which is difficult to distinguish from inflammatory carcinoma. The diagnosis is made by histopathologic examination of the specimen, in which we can see the characteristic sulfur granules representing the bacterial colonies. Prolonged antibiotic therapy with penicillin is the treatment of choice.

Background: A number of randomized trials addressing alternative operative and multimodality approaches to gastric cancer have characterized early postoperative morbidity and mortality rates. The aim of this study was to compare mortality and morbidity and disease free survival after D1 and D2 gastrectomy for adenocarcinomas of the stomach Materials and Methods: From June 2006 to January 2012, patients were selected according to information of the cancer administrator center of Ahvaz Jundishapur Medical University. The inclusion criteria were age between 20-85 years and histologically proven adenocarcinoma of the stomach without evidence of distant metastasis. Patients were excluded if they had previous or coexisting cancer or disability disease. In this research, D1 was compared to D2 gastrectomy. Results: 131 patients were randomised, 49 allocated to D1 and 82 to D2 gastrectomy. The two groups were comparable for age, sex, site of tumors, and type of resection performed. The overall post-operative morbidity rate was 17.5%. Complications developed in 14.2% of patients after D1 and in 19.5% of patients after D2 gastrectomy (p=0.07). Postoperative mortality rate was 0.8% (one death); it was 2% after D1 and 0% after D2 gastrectomy. In this research disease free-survival after 3 years was 71.2 % with 63.2% after D1 and 76.8% after D2 gasterctomy. Conclusions: This study indicates that D2 gastrectomy with pancreas preservation is not followed by significantly higher morbidity and mortality than D1 resection. Based on the results of present study, D2 resection should be recommended as the standard surgical approach for resectable gastric cancer.

Aim: The aim of this study was to compare post-operative C-reactive protein (CRP) between cases which underwent open appendectomy and laparoscopic appendectomy. Material and methods: This study was conducted on patients admitted for appendectomy in Imam Khomeini and Razi hospitals. Patients with perforated and gangrenous appendicitis, another pathological condition, renal failure, liver failure, history of taking drugs that interact with C-reactive protein (CRP), and pregnancy were excluded from this study. Cases were divided into children (5-15 years) and adults (16-65 years). Patients were randomly selected for open or laparoscopic appendectomy. SPSS version 16.0 (SPSS Inc, Chicago, IL, USA) was used for data analysis. T-test was used for comparison. Pearson and Spearman tests were used for correlation analysis. Results: There were no significant differences between CRP levels after laparoscopy in children vs. adult cases (p-value > 0.05, t-test). There was no significant difference between children and adults in pre-op CRP. There were significant differences between children and adults for 12 h and 24 h level of CRP after laparoscopic appendectomy (p < 0.05, t-test). Mean level of CRP in adults was significantly higher than children (p < 0.05, t-test). Level of CRP, 12 h after the procedure, was significantly higher in open appendectomy compared to laparoscopic surgery in adult cases (p = 0.09, t-test). In cases with body mass index (BMI) < 25 kg/m 2 , there was no significant difference between level of CRP before and after open or laparoscopic surgery. In cases with BMI ≥ 25 kg/m 2 , there was no significant difference between level of CRP of open and laparoscopic surgery (p > 0.05, t-test). Duration of surgery had no effect on level of CRP (p > 0.05, t-test). Conclusions: There was no significant difference between level of CRP after open and laparoscopic appendectomy, except in adult women. Level of CRP, 12 h and 24 h after surgery, was significantly higher in adult cases than children.

Background: Injury to the external branch of the superior laryngeal nerve (EBSLN) results in deterioration of postoperative voice performance. The aim of this study was to asses the impact of exploring and identifying the EBSLN during thyroidectomy in reducing nerve injury and consequently preserved voice performance. Methods: Ninety patients, in 2 groups, underwent a thyroidectomy and a total of 122 upper poles were dissected. After 2 to 4 weeks, patients with voice complaints were evaluated by electromyography of cricothyroid muscle. Results: There were 4 unilateral injuries (10%) in the explored group whereas in the non-explored group (9 unilateral and 2 bilateral) (P = 0.28), there were 11 (22%). A total of 7.4% of 54 upper thyroid poles injuries were observed in the explored group whereas 16% injuries of 68 upper thyroid poles in the non-explored group (P = 0.12). Conclusions:The injury to the EBSLN decreased when upper thyroid pole dissection was accompanied with nerve exploring. The EBSLN should be explored and identified during the thyroidectomy because it makes a noticeable change in the postoperative voice performance.