Diabetes mellitus is considered a silent disease with possible late chronic complications such as diabetic foot ulcer. This condition is managed by surgical debridement. To improve surgical outcome, some surgeons use proteolytic agents after surgery. Kiwifruit contains a type of proteolytic enzyme called actinidin that may play a role in the treatment of such complication. In the current study, we evaluate the role of kiwifruit extract in the treatment of diabetic foot ulcer. Eighteen diabetic foot ulcer patients were included in a randomized, double-blind clinical trial. The patients were divided randomly to control and experimental groups. Patients in the control group underwent daily wound dressing using base ointment (Eucerin). In the experimental group, we added kiwifruit extract to the standard wound dressing. Clinical data including general appearance of wound (according to recorded photographs before and after medical intervention) were analyzed using SPSS version 22. The mean wound area of the experimental group was significantly less than in the control group ( P = .005) after 4 weeks of treatment. Comparison of the average of size difference, before and after the treatment in the experimental group and the control group, shows that kiwifruit can have a good impact on wound healing ( P = .0001). In patients with diabetic foot ulcer, wound dressing using kiwifruit extract may help reduce time of treatment and may replace surgical debridement for some selected cases.

A 27-year-old lady was presented to emergency department complaining of macromastia and fever. The first pregnancy had a normal course. Three months after stopping breastfeeding, she noticed enlarging of the breasts. Danazol and Bromocriptine were not effective. For the second time she became pregnant and then she did an abortion at 8 weeks of gestation. Despite termination of pregnancy, the enlarging of breasts continued. The breasts were huge and reached about 20 cm below iliac crests (Fig. 1). The right one was larger than the left, with multiple ulcers on them and diffuse mastitis.The patient was resuscitated and antibiotics were begun, but there was no remarkable recovery. Bilateral simple mastectomy was done and nipple-areola complex was grafted in the lower part of the abdomen (Fig. 2).Gestational hypertrophy of breast is defined differently as massive discomforting enlargement of