Sayed Reza Ahmadi; Maliheh Ziaee; Humain Baharvahdat; Zahra Ahmadi; Morteza Talebi delouee; Behrange Rezvani Kakhki; Mohammad Salehi kareshk; Elnaz Vafadar Moradi
Volume 12, Issue 1 , January 2024, , Pages 35-41
Abstract
Objective: Subarachnoid hemorrhage (SAH) is still considered a life-threatening medical condition witha high mortality rate, particularly in developing countries. Thus, the present study aimed to investigate theangiographic findings of non-traumatic or spontaneous SAH.Methods: This retrospective cohort ...
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Objective: Subarachnoid hemorrhage (SAH) is still considered a life-threatening medical condition witha high mortality rate, particularly in developing countries. Thus, the present study aimed to investigate theangiographic findings of non-traumatic or spontaneous SAH.Methods: This retrospective cohort study included 642 health records of patients with non-traumatic SAH overa 10-year period, from 2010 to 2020. The required data, including demographic information, aneurysm type,size, location, disease severity classification, and secondary complications, were extracted.Results: The study included 642 patients, with 262 (40.8%) being male. The mean age of the participants was54.72±13.51 years. The most prevalent type of aneurysm was saccular (89.1%), while serpentine (0.2%) anddissecting saccular (0.2%) aneurysms had the least prevalence. The most frequently involved arteries were theanterior communicating artery (ACoA; 38%), internal carotid artery (ICA; 27.6%), and middle cerebral artery(MCA; 13.4%). There was a significant correlation between sex and aneurysms occurring at ACoA and ICA(p< 0.0001), and ACoA – A1 (p=0.02). Patient age and sex were also significantly correlated with one another(p<0.0001). There was no statistically significant correlation between sex, aneurysm size, Glasgow coma scale(GCS), and modified Rankin scale (MRS).Conclusion: Based on our findings, the presence of aneurysms at ACoA, ACoA – A1, and ICA should bethoroughly ruled out in patients with severe headaches of sudden onset, particularly male patients of youngerages.
Rahimeh Eskandarian; Abolfazl Abdollahpour; Shahrzad Aghaamoo; Narges Amini; Hoda Zangian; Kamran Ghods
Volume 10, Issue 3 , July 2022, , Pages 138-140
Abstract
Nowadays, the use of central venous catheter insertion (CVC), has abundantly increased. It is a common technique in critically ill patients who are admitted to intensive care and emergency departments in order to hemodynamic monitoring and fluid and medication administration. In this report, ...
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Nowadays, the use of central venous catheter insertion (CVC), has abundantly increased. It is a common technique in critically ill patients who are admitted to intensive care and emergency departments in order to hemodynamic monitoring and fluid and medication administration. In this report, we express a 28-year-old man who has multiple trauma with decreased level of consciousness during a car accident three months ago and needs intensive care and monitoring by central venous catheter placing. A missed guide wire remaining inside the venous system after peripherally inserted in femoral vein that was incidentally diagnosed by taking a chest X-ray after three months. Although, guide wires are often retrieved by snaring catheter under fluoroscopic guidance and an interventional cardiologist, we have successfully extracted the lost wire through vascular surgery. Eventually, this report is supposed to increase awareness of this rare and preventable complication and to provide a solution to prevent this complication. Finally, the purpose of this report is to emphasize that surgical extracting is the best intervention to remove the missed guide wire (after 3 months) and this optioncould be developed, introduced and standardized in appropriate and controlled conditions.
Saqer M Althunayyan
Volume 7, Issue 1 , January 2019, , Pages 21-27
Abstract
Endotracheal intubation is a lifesaving procedure that is performed in various settings within the hospital or even in the pre-hospital field. However, it can result in serious hemodynamic complications, such as post-intubation hypotension (PIH) and cardiac arrest. The most promising predictor of such ...
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Endotracheal intubation is a lifesaving procedure that is performed in various settings within the hospital or even in the pre-hospital field. However, it can result in serious hemodynamic complications, such as post-intubation hypotension (PIH) and cardiac arrest. The most promising predictor of such complications is the shock index (SI), which holds great prognostic value for multiple disorders. On the other hand, most of the studies that have assessed the predictability of the pre-intubation SI have been small and were limited to a particular setting of a single center; thus, the results were not generalizable, and the predictive value vary according to the setting. This review comprehensively assessed the utility of the pre-intubation SI for predicting PIH and post-intubation cardiac arrest by classifying and comparing evidence compiled from various settings, such as pre-hospital settings, emergency departments (EDs), intensive care units (ICUs), and operating rooms (ORs). The vast majority of these studies, conducted in ED and ICU settings, which revealed a significant correlation between an elevated SI and PIH or post-intubation cardiac arrest. The reliability and simplicity of obtaining a pre-intubation SI value are important considerations that encourage the extension of its use to all in-hospital intubations. Further studies are required to assess the predictive value of the SI in the pre-hospital setting.
Nawal Kishore Jha; Sanjay Kumar Yadav; Rajshekhar Sharma; Dipendra Kumar Sinha; Sandip Kumar; Marshal Daud Kerketta; Mini Sinha; Abhinav Anand; Anjana Gandhi; Satish Kumar Ranjan; Jitin Yadav
Volume 2, Issue 4 , October 2014, , Pages 156-160
Abstract
Objective: To determine the presentation, anatomical distribution, diagnostic method, management and outcome of hollow viscus injury (HVI) from blunt abdominal trauma.Methods: This was a retrospective cross-sectional study including patients with blunt abdominal trauma leading to HVI admitted at Rajendra ...
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Objective: To determine the presentation, anatomical distribution, diagnostic method, management and outcome of hollow viscus injury (HVI) from blunt abdominal trauma.Methods: This was a retrospective cross-sectional study including patients with blunt abdominal trauma leading to HVI admitted at Rajendra Institute of Medical Sciences, Ranchi, over a period of 4.5 years (January 2009 to July 2014). Data were retrieved from patients’medical records. Total 173 patients with HVI due to blunt abdominal trauma, who underwent laparotomy at our institute, were reviewed. Data regarding clinical presentation, anatomical distribution, management and outcome were recorded and analysed.Results: Out of 173 patients 87.1% were men and 12.9% were women. Mean age of patients was 29 ± 14.02 years. The most common site of injury was ileum (46.2%) followed by jejunum (44.5%). There were 5 gastric perforations (2.9%), 2 (1.15%) duodenal, 2 (1.15%) colonic, 2 (1.15%) sigmoidal and 2 (1.15%) rectal injuries. One caecal injury was also recorded. Road traffic accident was the most common mechanism of injury (57.2%) followed by fall from height (36.4%) and assault (6.4%). Free gas under diaphragm on erect abdomen radiography was seen in 85.5% of cases while preoperative CT Abdomen was done in 11.6% of cases. Treatment consisted of simple closure of the perforation (66.5%), resection and anastomosis (11.0%) and stoma (22.5%). Major complication was anastamotic leak which was recorded in 6.4% cases and 15.6% patients developed burst abdomen. Average hospital stay was 13 ± 6 days. Overall mortality rate was 12.7%. Conclusion: Although early recognition of intestinal injuries from blunt abdominal trauma may be difficult in all cases, it is very important due to its tremendous life threatening potential. Age of the patient, anatomical site and time of presentation are probably main prognostic factors.