Objective: The cows that don’t have access to sufficient energy in their ration can get sickness. Milk production has a high priority in metabolism of dairy cows so lactating cows are more prone to get sick This can ruin all the benefits of higher milk yield because of the higher prevalence of the disorders.Methods: Data for this research had gathered from a herd with 1600 Holstein cattle in East Azarbayjan province of Iran. Data were from 5052 lactation period of 1796 Holstein-Frisian cows which had parturition among 2005-2009. Seven groups of disorders have been analyzed. They are as follow: Cecal dilatation and rotation, diarrhea, abomasal distention and displacement to the right or left, locomotion problems and metritis. Each model consists of milk yield, parity, season and the year of calving. To determine the correlation between 305-day milk yield and occurring of disorders data have been analyzed with logistic regression model.Results: In this research current lactation was used as the lactation with occurrence of particular disorder. According to performed analysis on all cattle (heifers and the cows) higher milk yield was not a risk factor for the disorders occurrence except for diarrhea. Our outcomes showed a negative correlation between milk production with abomasal distention and left abomasal displacement. Analysis of correlation between prevalence of the disorders and 305- day yield showed a negative correlation with abomasal dilatation and displacement to the left and a positive correlation with diarrhea. Parity had a negative correlation with cecal rotation and dilatation, and a positive correlation with diarrhea. The year of calving had a significant correlation with abomasal dilatation and displacement of that to the right, cecal dilatation and rotation, diarrhea and locomotion problems. Calving season had only a significant relationship with cecal dilation and rotation. This research showed a complete correlation between some diseases and disorders in dairy cows and parameters that refer to milk production.

Sir, the recent publication on hyperbilirubinemia and pelvicaliceal dilatation is very interesting. Akil et al concluded that "hyperbilirubinemia might not have a direct effect on outcome of the pelvicaliceal dilatation." There were several problems on this work that limited the conclusion.

Question 2 A 51-year-old Caucasian female with a past history of hypertension and hypothyroidism presented for a screening colonoscopy. Her surgical history was significant for a total abdominal hysterectomy. Abdominal examination was normal and laboratory findings were unremarkable. CT scan of the abdomen was performed which did not show any abnormalities or pathologies upon read...

Dear Editor-in-Chief Herein we describe a 51-year-old male patient had intermittent abdominal pain and constipation during last two years. He admitted to general surgery clinic because of lately onset severe abdominal cramps, nausea and vomiting and due to bleeding during defecation. Colonoscopic examination revealed a mass lesion in the cecum located approximately 5 cm in diameter. Because of the patient’s increasing complaints.

On contrast-enhanced thoracic CT images, severe dilatation of the superior and inferior vena cavae, suprahepatic veins and the right atrium can be seen. The aortic and mitral valves are prosthetic. Fatty infiltration and liver congestion are seen. The procedure was cancelled and the patient was referred for an echocardiographic study, which showed severe dilatation of the right atrium (more than 10 cm in diameter), severe tricuspid valve regurgitation and stenosis, elevated pulmonary artery pressure, dilatation of the ventricles with severe left ventricular dysfunction and normally functioning prosthetic valves.

Background/Objective: Esophagomyotomy and pneumatic dilatation are routine treatments of achalasia. The aim of this study is determine treat-ment effects of these methods. Patients and Methods: This historical cohort study was done in Esfahan city in 2006. Sixty-six patients with achalasia that treated with pneumatic dilatation (n=46) and esophagomyotomy (n=20) were studied. The data of age, clinical recovery, complications, and satisfaction were collected. Data were analyzed with T-test and x2 and p<0.05 was different significantly. Results: Clinical recovery was 70% with esophagomyotomy vs 80.5% with pneumatic dilatation (p>0.05). Mean of satisfaction was 8.5±2.37 in esophagomyotomy group Vs 7.68±2.49 in pneumatic dilatation group (P>0.05). Complications were not different significantly in two groups. Radiologic recovery was 66/6% in esophagomyotomy group vs 23.5% in dilatation group (P<0.5). Conclusion: Clinical recovery complications and sat-isfaction in two groups were not different significantly. This study shows need for long-term follow up in two groups.