Somaye Bazdar; Maryam Dehghankhalili; Shekoofeh Yaghmaei; Maryam Azadegan; Amirhossein Pourdavood; Mohammad Hadi Niakan; Ali Mohammad Bananzadeh
Volume 6, Issue 2 , April 2018, , Pages 122-127
Abstract
Objective: To determine the effects of pregnancy on the presentation, management, surgical and obstetrics outcome of patients with acute appendicitis.Methods: This prospective cohort study was conducted during a 2-year period from 2014 to 2016 in Shahid Faghihi hospital of Shiraz University of Medical ...
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Objective: To determine the effects of pregnancy on the presentation, management, surgical and obstetrics outcome of patients with acute appendicitis.Methods: This prospective cohort study was conducted during a 2-year period from 2014 to 2016 in Shahid Faghihi hospital of Shiraz University of Medical Sciences. We enrolled all the pregnant individuals with acute appendicitis who required surgical appendectomy. We also enrolled age-matched controls of non-pregnant women undergoing open appendectomy during the study period. The presentation, clinical and laboratory characteristics, surgical and obstetrics outcomes were determined in both study groups and were further compared between them. In order to determine the determinants of outcome, we also ran a multivariate logistic regression model.Results: Overall we included a total number of 584 patients with presumed appendicitis among whom there were 58 (9.94%) and 526 (90.06%) non-pregnant individuals. The pregnant patients had significantly longer duration of symptoms (p=0.038), lower temperature (p=0.026), longer duration of hospital stay (p=0.026) and higher rate of hospital admission longer than 2 days (p=0.031). The complications of the surgical procedure were comparable between the two study groups except for the pneumonia which was significantly higher in pregnant patient (p=0.041). After adjusting for confounders such as age and ethnicity, pregnancy remained significantly associated with lower temperature (p=0.018), longer symptom duration (p=0.042) and higher rate of pneumonia (p=0.049).Conclusion: Acute appendicitis during the pregnancy was associated with longer duration of symptoms, lower body temperature and higher rate of pneumonia. The pregnancy and neonatal outcomes were comparable to the previously reported data.
Shahram Paydar; Behnam Dalfardi; Bardia Zangbar-Sabegh; Hossein Heidaripour; Leila Pourandi; Alireza Shakibafard; Mehdi Tahmtan; Leila Shayan; Mohammad Hadi Niakan
Volume 6, Issue 1 , January 2018, , Pages 26-30
Abstract
Objective: To determine the predictive value of repeated abdominal ultrasonography in patients with multiple trauma and decreased level of consciousness (LOC).Methods: This prospective cross-sectional study was conducted over a six-month period at Shahid Rajaee Trauma Hospital, Shiraz, Iran. We included ...
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Objective: To determine the predictive value of repeated abdominal ultrasonography in patients with multiple trauma and decreased level of consciousness (LOC).Methods: This prospective cross-sectional study was conducted over a six-month period at Shahid Rajaee Trauma Hospital, Shiraz, Iran. We included hemodynamically stable blunt abdominal trauma patients with a decreased LOC (Glasgow Coma Scale ≤ 13) who were referred to the neurosurgery ICU ward. Included cases underwent 1 contrast-enhanced CT scan and two-time ultrasonographic study of the abdomen with an interval of 48 hours. The diagnostic accuracy of the ultrasonography was determined according to the CT-scan results.Results: Overall 80 patients with mean age of 37.75 ± 18.67 years were included. There were 17 (21.3%) women and 63 (78.8%) men among the patients. Compared with the CT-Scan, the first ultrasonography showed a sensitivity of 60%, specificity of 80%, PPV of 16.60%, NPV of 96.80%, and a diagnostic accuracy of 70%. The same values for the second ultrasonographic study were 80%, 79%, 20%, 98%, and 79%, respectively. In 4 (5%) patients whose first ultrasonography and CT scan results were negative, the second ultrasonography was positive for injury.Conclusion: In patients with blunt trauma to the abdomen, when the only indication of abdominal CT scan is a decreased LOC, two ultrasonographic studies can replace a CT imaging.
Shahram Paydar; Zahra Ghahramani; Hamed Ghoddusi Johari; Samad Khezri; Bizhan Ziaeian; Mohammad Ali Ghayyoumi; Mohammad Javad Fallahi; Mohammad Hadi Niakan; Golnar Sabetian; Hamid Reza Abbasi; Shahram Bolandparvaz
Volume 3, Issue 2 , April 2015, , Pages 37-40
Abstract
Chest tube (CT) or tube thoracostomy placement is often indicated following traumatic injuries. Premature movement of the chest tube leads to increased hospital complications and costs for patients. Placement of a chest tube is indicated in drainage of blood, bile, pus, drain air, and other fluids. Although ...
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Chest tube (CT) or tube thoracostomy placement is often indicated following traumatic injuries. Premature movement of the chest tube leads to increased hospital complications and costs for patients. Placement of a chest tube is indicated in drainage of blood, bile, pus, drain air, and other fluids. Although there is a general agreement for the placement of a chest tube, there is little consensus on the subsequent management. Chest tube removal in trauma patients increases morbidity and hospital expense if not done at the right time. A review of relevant literature showed that the best answers to some questions about time and decision-making have been long sought. Issues discussed in this manuscript include chest tube removal conditions, the need for chest radiography before and after chest tuberemoval, the need to clamp the chest tube prior to removal, and drainage rate and acceptability prior to removal.
Hamid Reza Abbasi; Seyed Mohsen Mousavi; Ali Taheri Akerdi; Mohammad Hadi Niakan; Shahram Bolandparvaz; Shahram Paydar
Volume 1, Issue 2 , April 2013, , Pages 81-85
Abstract
Objective: To record and classify mechanisms of injury and injury severity score (ISS) in trauma patients admitted to the largest trauma center in Southern Iran.Methods: This was a prospective cross-sectional study including all the patients who were admitted to Nemazee hospital from 2009 to 2010. We ...
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Objective: To record and classify mechanisms of injury and injury severity score (ISS) in trauma patients admitted to the largest trauma center in Southern Iran.Methods: This was a prospective cross-sectional study including all the patients who were admitted to Nemazee hospital from 2009 to 2010. We recorded the trauma injury information of 1217 patients who were admitted to of emergency room of the Nemazee hospital during a 13-months period by means of a standard questionnaire. ISS was then obtained for every single patient.Results: The mean age of patients was 26.6 ± 15.1 (range 1–95) years. The commonest type of trauma including 279 cases (22.9%) was car accident and the least resulted from shotgun injuries in 13 (1.1%) patients. The lowest ISS was due to assault multiple blunt traumas and the highest ISS resulted from shotgun injury. The mean ISS was about 6.3 ± 1.8 (range 1-66). Overall, 86 patients had scores above 17 (7.1%). A total of 69 male patients (7.5%) compared to 17 females (5.7%) had severe injury (ISS>17). Trauma injuries were significantly more severe in males compared to females (p=0.014). In the sunny and hot seasons total number of patient was higher. The mean ISS was highest in during spring (p<0.001).Conclusion: In Shiraz, most of the trauma injuries are occurred during summer and hot weather. Men have greater number of injuries and higher ISS compared to women. The lowest ISS was due to assault multiple blunt trauma and the highest ISS was caused by shotgun injury, and car accident was the commonest cause of trauma with head and neck being the most frequent sites in our patients.