BackgroundIn candidate patients for permanent hemodialysis or dialysis on a regular basis, an appropriate vascular access has great importance. The best permanent access is AVF (arterio venous fistula). Use of a technique to create AVF with better patency seems to be logical.ObjectivesThe present study aimed to compare the efficacy rate of AVFs using two different anastomosis methods; Side to Side (STS) versus End to Side (ETS) and to determine whether the different approaches render any preferences or complications.Patients and MethodsSixty end stage renal disease (ESRD) patients were included in this clinical trial in two assigned groups of 30 patients. In one group end to side method to create AVF was used while in the other group Side to Side technique was applied for access in surgery. Both groups were followed for duration of 6 months to assess patency. For evaluating the quantitive variables, t-test was used while qualitative variables were measured using the chi-square and Fisher`s exact tests.ResultsIn the 6 months duration, 6 patients (20%) in the STS (side to side) group and 5 patients (16.6%) in the ETS (end to side) group experienced a non-functional AVF. In the ETS group the failure was generally a result of thrombosed access while in the STS group, 4 out of 6 patients with complications, experienced thrombosis while the other 2 patients had venous hypertension. The total failure rate was 18.3% and during the 6 months of follow up no significant difference was detected in the efficacy rate. Nevertheless, in case of longer follow ups, different outcomes could be seen.ConclusionsThis study demonstrated that there was no significant statistical difference between the functional patency rates of fistulae placed by STS or ETS methods.

IntroductionSplenic artery aneurysms (SAAs) are rare (0.2-10.4%); however, they are the most common form of visceral artery aneurysms. Splenic artery aneurysms are important to identify, because up to 25% of the cases are complicated by rupture. Post- rupture mortality rate is 25% -70% based on the underlying cause. Herein we present a young patient with abdominal pain after blunt abdominal trauma due to rupture of an SAA.Case PresentationA 27-year-old male, without a remarkable medical history, who suffered from abdominal pain for 2 days after falling was admitted to the emergency department with hypovolemic shock. Upon performing emergency laparotomy a ruptured splenic artery aneurysm was found.ConclusionsIt is important to consider rupture of a splenic artery aneurysm in patients with abdominal pain and hypovolemic shock.

Two cases of pyogenic granulomas in burned skin were presented, a 17-month-old boy and a 7-year-old girl, being given oral propranolol and topical timolol. Both cases showed lesions improvement with no adverse effects, suggesting that betablocker therapy may have a positive impact on the treatment of pyogenic granuloma after burns. K E Y W O R D Sbeta-blocker, burn, hemangioma, oral beta-blocker, post-burn hemangioma, post-burn pyogenic granuloma, propranolol, pyogenic granuloma, therapy, timolol, topical beta-blocker, treatment How to cite this article: Ebrahimi Z, Mahdi Z, Khairi AA, et al. Oral propranolol and topical timolol in the treatment of post-burn pyogenic granuloma: Two cases and a review of the literature.