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BACKGROUND AND OBJECTIVE: The term middle lobe syndrome identified with recurrent right middle lobe atelectasis or lingual that resulted from bronchectasis, TB, malignancy, etc. This syndrome was characterized by chronic cough, hemoptysis and repeated respiratory infection. In this report, hydatid cyst is very rare cause of this disease.
CASE: A 71-year-old man was presented with cough contain bloody sputum but he did not have fever and dyspnea, also sputum BK (Kochs bacillus) smear was negative. The patient repeatedly treated with different antibiotics but not cured. CT scan showed the consolidation in right middle lobe. Fiberoptic bronchoscopy revealed inflammation and erythema in right middle lobe and right lower lobe division. Since the patient did not respond to medical therapy, with diagnosis middle lobe syndrome was operated. Pathology report revealed hydatid cyst.
CONCLUSION: Hydatid cyst as one of the etiologic factors of middle lobe syndrome especially in endemic area should be considered and surgery is the only treatment for this disease.

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BACKGROUND AND OBJECTIVE: At present despite of wide spread application of tracheal tube with low-pressure cuff, complications of tracheal intubation have not disappeared. The main factor in post intubation tracheal stenosis is high cuff pressure that can cause stimulation and damage of trachea mucosa and thus, it causes scar after extubation. This study was done to define the complications of pressure effects of tracheal tube cuff on trachea.
METHODS: This study is a cross-sectional study over 60 patients of ICU, who have been intubated for ≥24 h. In this study cuff pressure was measured every 6h by a cuff pressure monitor and were registered. Then after 2h, 24h, one weak, one month and 3 months after extubation, patients were followed. Presence of cough, stridor and dyspnea were registered. Any doubt of tracheal stenosis was followed by rigid bronchoscopy. Data was recorded and assessed.
FINDINGS: The mean age of patients was 45.36±11.3 years that 37 (61.66%) were male and 23 (38.3%) were female. Among patients without pulmonary disease, there were 16 patients (26.66%) with cough and stridor in the first 2 or 24h of extubation but all of them became asymptomatic in following up. Except one patient that because of cough, stridor and dyspnea in the first 24h was undergone rigid bronchoscopy with finding of atelectasis and collaps of lung, no tracheal stenosis or its complications were found.
CONCLUSION: It seems that maintenance of cuff pressure in the range of 20-30cm H2O and its regular monitoring is the best method for prevention of cuff pressure complications.

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BACKGROUND AND OBJECTIVE: The lesson plan is written description of education process in which is shown what, when, where and with which method should be learned and how students will be assessed. The aim of this study was to evaluate the lesson plans of faculty members of medical and dental schools of Babol University of medical sciences, Babol, Iran.
METHODS: In this cross sectional study, lesson plan of all faculty members of medical school (clinical and basic sciences) and dental school who participated in workshop of principles of writing lesson plan was assessed. In initial assessment of lesson plans, existing problems noted and explained to authors in individual meetings. Studied items included specifying the instructors name, lesson name, using educational devices and etc. Score for specified and non specified items was one and zero, respectively. Then groups were compared with each other.
FINDINGS: In this study, 100% of faculty members of basic sciences, 91.3 % of faculty members of clinical sciences and 100% of dental school faculty members use the lecture as a teaching method. Power point and video projector are the most common educational aid devices which used by 75% of faculty members of basic sciences, 57.1 % of faculty members of clinical sciences and 100% of faculty members of dental school. Formative examinations (quiz, midterm test and etc) were used to evaluate students by 58.3 % of faculty members of basic sciences, 14.2 % of faculty members of clinical sciences and 0% of faculty members of dental school.
CONCLUSION: The results of this study show that most faculty members do not use formative examinations to evaluate the students and they do not prepare a written lesson plan. More planning is necessary to resolve the problem in order to faculty members are required to have written lesson plan as routine work.

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BACKGROUND AND OBJECTIVE: Inguinal hernia repair is one of the most prevalent procedures in general surgery. Several methods have been introduced for inguinal hernia repair that focus on the reduction of complications of surgery and lowering the recurrence of the hernia. However, controversies remain among surgeons about the preferred treatment method. The aim of this study was to compare the outcomes of repairing inguinal hernia with mesh and non-mesh methods.
METHODS: All patients aged 18 years old and over that admitted for inguinal hernioraphy in Shahid Behesti hospital in Babol during March to September 2010 included in the study. Demographic data, characteristics of hernia, duration of returning to daily activities and the type of repair of each patient entered in the checklist. All patients followed up for one year in case of any complication and recurrence of hernia. Recurrence of hernia due to ascites or due to any increase in abdominal pressure and missed patients during the follow up period was excluded from the study.
FINDINGS: Among all 132 cases 129 patients were male and 3 patients were female and the mean age of the patients was 53.66±16.89 years. Forty five (34.1%) patients underwent hernioraphy with mesh and 87 (65.9%) patients without mesh. The mean time for patients to return to daily activities was 25.4±4.7 days in the mesh group and 28.53±7.86 days in the non-mesh group (p=0.048). Rate of recurrence of hernia during the follow up period was 8 cases (6.1%) that 6 cases had been repaired with non-mesh method and 2 cases were repaired with mesh method (p>0.05).
CONCLUSION: Simple inguinal hernias seem to be repaired better with mesh method than non-mesh method.