Lipoid proteinosis is a rare autosomal-recessive disturbance characterized by yellowish-white deposits on the inner surface of the lips, under surface of the tongue and uncommonly other surfaces of upper respiratory tract. Changes in larynx lead to degrees of hoarsness which usually appears within the first few weeks of life after initiation of the disease.

  The patient tongue is firm like as wood. In some patients deposits observed on the vocal cords, labia major, scrotum, gluteal folds and axilla. The eyelid margins contain yellowish pearly papules in about ²/₃ of patients. Neurologic findings such as epilepsy are rare but pathognomonic. The gene of these disturbances is recognized on 1q21 choromosome. The patient reported here is a 13 years old girl with yellowish pearly papules on the margins of her eyelids and hoarsness. Diagnosis of lipoid proteinosis is confirmed by pathologic findings.

 The OHS is characterized by hypersomnolence, hypoxia, polycytemia, headache and edema. Polysomnography is the gold standard diagnostic test. Overnight oximetry with significant oxyhemoglobin desaturation is reasonable to begin treatment. Weight reduction and Non invasive positive pressure ventilation (NIPPV) has evolved as the mainstay of treatment.

 Obesity is a risk factor for deep vein thrombosis (DVT). Heparin and warfarin are the drugs that used for treatment of DVT. HIT typically appears as a 50% or greater reduction in the platelet count after the first exposure to heparin. This case is a obese man with extreme DVT that diagnosed by duplex sonography and symptoms of obesity hypoventilation syndrom.

 In overnight pulseoximetry oxyhemoglobin desaturation was occurred more than 15 times per hours and treatment begins with NIPPV. Patients thrombosis were treated with heparin and warfarin. Heparin induced thrombocytopenia (HIT) and cutaneous necrosis was occurred and drug therapy withdrawn. After healing of cutaneous necrosis low dose warfarin was started.

 NIPPV promote airway occlusion and improve hypercapnia.hypoxia and quality of life and reduced cardiovascular complications.

 Lipomas are common benign soft tissue neoplasms but they are found rarely in the parotid gland .

 Surgical intervention in these tumors is challenging because of the proximity of the facial nerve, and thus meticulous surgical techniques are essential. The patient was a 12-year-old female presented with a large asymptomatic mass which had occupied the right facial area. She requested surgical excision for cosmetic reasons. The CT scan defined giant lipoma arising from the right parotid gland. The lipoma was successfully removed after dissecting and preserving of the facial nerve branches. The patient experienced an uneventful recovery, with and intact facial nerve function .

 Lipomas of parotid gland are extremely rare. The high- resolution CT scan provides a prefer method of preoperative diagnosis. Surgical management should be performed by experienced surgeon. Superficial parotidectomy is unnecessary in selected cases of deep lobe lipomas because preservation of superficial lobe may contribute to better cosmetic results .

  Uterus leiomyomas are the most common benign tumors and usually are asymptomatic. This article is a report of an approximately large Myoma (12 × 12 × 21 cm). The subject was a 40-year-old woman with pelvic fracture. While examining, a large mass was found in the pelvic. The patient was transferred to the operation room to further examination. During the surgery an almost constant but stiff mass was found in hypogastrium that overextended to the umbilicus. For the last few months, the patient had some disorders such as constipation and oligomenorrhea but these disorders were not important and discomfortable complaining for the patient. Patient was clinically assumed to have ovarian tumor and referred for laparotomy. After surgery, pathological examination showed that it was a subserosal Myoma.

  Protein C is a vitamin K dependent glycoprotein. Protein C deficiency is a rare genetic disorder and its major sites of involvement are skin, eyes, lungs, central nervous system, and kidneys. This article presents a case of neonatal protein C deficiency with severe purpura fulminans and bilateral cataracts. He was initially treated with fresh-frozen plasma and then followed by warfarin. All necrotic skin lesions improved with treatment. He was the first child of his parents who were asymptomatic for protein C deficiency. We also reviewed literatures about coexistence of cataracts and protein C deficiency.

  Hydatid disease infection in humans is caused by larva of Echinococcus granulosus. Definitive hosts are carnivores such as dogs, while intermediate hosts are herbivores. Humans can also be intermediate hosts. Hydatid disease is clinically related to the presence of cysts, most frequently in the liver and the lungs and less frequently in the other organs such as kidney, spleen, brain, heart and bone. In this article, a case of splenic hydatid cyst is reported. A 50-years-old man was admitted to the clinic with a abdominal pain lasting for two weeks. Sonography and computed tomography (CT) scan revealed a splenic cyst. Cyst was removed by a surgery. The diagnosis of a hydatid cyst was confirmed by histopathology.

  Thyroid hormones play an important role in the growth and function of the kidneys. Hypothyroidism has known role in kidney filtration system disorders. We reported hypothyriod patients with nephrotic syndrome recruited by hypothyroidism treatment. Although hypothyroidism coincidence with nephrotic syndrome has been recognized but often is missed in regard with nephrotic syndrome.

  Eosinophilic gastroenteritis is a rare disease characterized by focal or diffuse eosinophilic infiltration of the gastrointestinal system. The clinical presentation is depending on the involved area and its extension into the layers of the gastrointestinal tract. We repor ted a case of eosinophilic gastroenteritis in the setting of cryptogenic cirrhosis which initially appeared as a tumoral obstruction of the 3^rd portion of duodenum which is relieved by surgical bypass and two years later presented as eosinophilic ascitis. The patient was treated with corticosteroid with full absorption of ascitis.

  Extramedullary plasmacytomas are rare solitary soft tissue tumors that arise from proliferations of malignant transformed monoclonal plasma cell. Though they are closely related to multiple myelomas, they have better prognosis. The tumor is eradicated by surgery or local radiation therapy. This is a case-report study of solitary plasmacytoma tumor which involved left side maxillary sinus and underwent excisional biopsy confirmed by IHC.

  Background & objectives: Eisenmenger syndrome associated with pregnancy increases the maternal morbidity and mortality . Therefore, in the most of such patients the termination of pregnancy is recommended.

  Case report: A 29 -year-old woman at the 7 ^th week of gestational age was candidate for therapeutic abortion with history of Eisenmenger syndrome due to atrial septal defect (ASD) . Spinal a nesthesia was performed in sitting position at the L4-5 interspace with 10 mg of bupivacaine . The p atient was laid in the supine position after 2 minutes. The surgery lasted about an hour . Blood pressure and heart rate did not change significantly during operation.

  Conclusion : Modified s pinal anesthesia with bupivacaine is recommended for therapeutic abortion in patients with Eisenmenger syndrome.

  Introduction: Complete Amputation of wrist is physical and psychological trauma that can affect person's life. During recent years, various amputated organs were replanted back into their own body leading to improvement in quality of life, function and body image.

  Case Report : The case was a34 years old man with complete amputation at left hand at wrist level, while working with chainsaw. Patient was admitted to the emergency unit at Fatemi hospital of Ardabil city, and underwent tosurgery for replantation.

  Conclusion: Complete amputation of wrist and its successful replantation are among rarely occured and reportable cases . The5 -month follow-up indicated a successful operation . During this period, no abnormalities were found in the blood circulation . The finger grasping and nerve development were acceptable and no symptom of infection was observed

  Background &objectives: Echinococcosis, referred to as hydatid disease or hydatidosis, is a parasitic disease caused by larval stage of Echinococcus granulosus. In the life cycle of this parasite, dogs and other carnivores are definitive hosts and herbivores are intermediate hosts. Humansin this cycle may incidentally involve by ingestion of parasite eggs and play as intermediate host. Hydatid disease can involve any organ but liver and lung are the most commonly affected organs and kidney, brain, heart, bone may also be affected to a lesser degrees. Cerebral hydatid cyst occurs in about 2% of all echinococcosis cases. In this paper we report two cases of cerebral echinococcosis in whom diagnoses were made based on MRI findings and confirmed by pathology reports after surgery.

  First Case Report: The first case was a 30 years old man who was admitted after an episode of generalized tonic-clonicseizure. The MRI imaging performedand patient underwent surgery with diagnosis of a right frontal cystic lesion. The patient was improved progressively and there was no seizure attack and recurrence during 18 months follow up period.

  Second Case Report: The second case was a 28 years old woman presented by headache and abnormal behavior. MRI of this patient revealed a large cystic lesion in left frontal lobe and then underwent surgery. No complication was seen during postoperative period. The headache and behavioral disorder were improved completely and there was no sign of recurrence during 18 months follow up period.

  Conclusion: Hydatid cyst should be considered as a differential diagnosis of cystic brain lesions in endemic areas. Although hydatid cyst is a benign lesion but surgical removal of it without rupture is very important for prevention of probable future complications.