There are several important prognostic factors for GSV recanalization and change of HRQoL after EVTA. However, the performance of each model was unsatisfactory to allow use in clinical practice yet.

Endovenous laser therapy (EVLT) for greater saphenous vein (GSV) insufficiency is a relatively new method of treatment only recently made available in Iran. This is the first long-term randomized trial comparing EVLT with high ligation of saphenous vein (HLS) in the Iranian population. Sixty-five patients met the inclusion criteria and were divided into homogenous treatment groups of EVLT (n = 30) or HLS (n = 35). Clinical severity, etiology, anatomy, pathophysiology (CEAP) classification and Aberdeen Varicose Vein Symptom Severity Scores (AVSS) were used to determine disease severity and symptoms before and after the procedure in both groups. Outcome was measured by the rate of recurrence as shown in Doppler ultrasonography evaluation. Follow-up was conducted 1 week and 3, 6, 12, and 18 months after the intervention. The occlusion rate of GSV was similar in both groups (93.6% for EVLT, 88.3 for HLS) at 18 months of follow-up. The median CEAP score showed a dramatic decrease in both groups after 1 week which was sustained for the rest of the study. The Aberdeen Varicose Vein Symptom Severity score was significantly lower in the EVLT group at 12 and 18 months of follow-up. There was no significant difference in patient satisfaction in both groups. Our findings show that EVLT may offer a better long-term relief of symptoms. This, alongside its better cosmetic outcome, and less invasive anesthesia requirements may make it the favorable choice for treatment of GSV insufficiency.

No abstract

Background: Appendicitis is the inflammation of the appendix. In spite of advances in the diagnosis and management of acute appendicitis, its morbidity is still significant. Despite widespread use of ultrasonography, computed tomography (CT) scan, and laparoscopy to diagnose appendicitis, the rate of misdiagnosis is not diminished accordingly. Methods: The current study aimed at determining the prevalence of primary misdiagnosis in pediatric patients presenting with appendicitis to Aliasghar Hospital, a tertiary referral center in Tehran, Iran from 2005 to 2015. Results: In the present study, the misdiagnosis rate of acute appendicitis was 7.4% in 10 years. Most causes of misdiagnosis were mesenteric adenitis, urinary tract infection, and gastroenteritis. Despite the availability of various diagnostic methods, the majority of patients with initial misdiagnosis were finally subjected to laparotomy for acute appendicitis. Ultrasound examination was useful in only 23% of the cases. Location of appendicitis in patients with initial misdiagnosis was retrocec in nine patients (53%), retroileum in five patients (29%), and pelvis in three patients (18%). Conclusions: Closer attention to signs and symptoms of acute appendicitis and higher clinical suspicion could reduce the rate of misdiagnosis and therefore minimize complications.

Necrolytic migratory erythma (NME) as a rare skin disorder that can affected Perineum, distal extremities, lower abdomen and face are the most commonly affected sites.It can be as a part of Glucagonoma syndrome that is defined as an association of glucagonoma with NME, hyperglucagonemia, glucose intolerance, anemia and weight loss. Here, Authors describe a woman admitted to the dermatology ward with NME which was later found to be associated with glucagonoma and multiple hepatic lesions.