Journal of Translational Medical Research

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Varicella is an acquired childhood disease and it is a mild and self-limited one, whose complications in older individuals can be life-threatening. These complications usually appear 3 to 4 days after the appearance of varicella exanthems including pain, recurrent fever>38.5 and toxic appearance. Airway complications of varicella are rare. Acute supraglottitis mostly involves 2 to 6 year old children. Its spread is extremely fast and air-way obstruction is due to cellulites of supraglottic structures. Airway examination in a patient with epiglottitis that is a rare complication of varicella infection must be done in controlled condition or in an operating room and by highly- skilled specialists (e.g. surgeons and anesthesiologists). The patient must be admitted to the intensive care unit and be treated with suitable and effective antibiotics and respiratory care. Otherwise, mortality rate will be high. We report a 21 year old patient with post-varicella epiglottits. The patient after 5 days of exanthema, developed sore throat, stridor, dyspnea with sternal and intercostals retraction, tachypnea, fever and tachycardia. Sever epiglottits was seen on nasopharyngoscopy in operation room. Therefore, emergency tracheostomy was done and post direct laryngoscopy epiglottits was established and biopsy was performed. The patient admitted to the intensive care unit treated by broad spectrum antibiotic and discharged after a week with good general condition and a prescription.

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Background and Aim: Elective tracheotomy is a common operation in hospitals in associations with intensive care unit. According to the high incidence of this operation and its importance, we designed our study by gathering information about patient including the most common and post operation complications.
Materials and Methods: In our retrospective study, all patients need tracheotomy in both Imam Reza and Vali-Asr hospitals in Birjand during 2000-2007 were studied. The most common indications of tracheotomy were coma, laryngeal cancer, thyroid cancer, sub glottis stenosis, respectively.
Results: In this study, 176 patients during 7 years were analyzed. 65.9% of cases were male, the most common indication for tracheotomy were long intubations (54%). Laryngeal cancer (26%). 39 patients (22.1%) were complicated. The most common post operative complications were hemorrhage of the site of operation (5.1%), Tube difficulties (4.5%), tracheal stenosis (2.85%), and the difficulties in deconolation (2.3%), sub cotaneous emphysema (1.7%), infection (1.7%), granulation tissues (1.1%) and others (2.85%).
Conclusion: According to prevalence of tracheotomy and its complications, more post-operative care of patients in ICU and emergency wards can be effective in reducing complications and having a better prognosis.

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Pilomatrix carcinoma is a very rare adenexal tumor which originates in the hair matrix cells and is marked by exophytic growing and common local recurrence, but the metastatic potential is limited. It was first described in 1980 by Lopansri and Mihm, and since then about 90 cases have been reported in the literature. There is no established treatment for the wide local invasion and metastasis of the pilomatrix except wide surgical resection. The case reported here was a 9-year-old boy with Pilomatrix carcinoma presented with a hard mass on the forehead but with normal overlying skin.