Original Article
Seyed Mohammad Hosseini Kasnavieh; kehan koukli; Mohamad veisi; mohammad Amerzadeh; Hossein Hosseinifar; Ali Tahmasebi
Articles in Press, Accepted Manuscript, Available Online from 01 October 2023
Abstract
Objective: This study aimed to investigate the necessity of cervical collars in patients with neck problems.Methods: This cross-sectional study was conducted on 114 patients who were admitted to the Haft Tir andRasoul Akram Hospitals (Tehran, Iran) from August to September 2022. The Nexus protocol was ...
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Objective: This study aimed to investigate the necessity of cervical collars in patients with neck problems.Methods: This cross-sectional study was conducted on 114 patients who were admitted to the Haft Tir andRasoul Akram Hospitals (Tehran, Iran) from August to September 2022. The Nexus protocol was used to selectthe patients with cervical collars. According to the protocol, a cervical collar was required for individuals whohad at least one symptom. If none of these symptoms existed, the cervical collar was deemed unnecessary. Thedata were analyzed using the Chi-square test and Fisher’s exact test.Results: Of the 114 trauma patients, the cervical collar was used unnecessarily by 49 (43%) patients. Tendernesswas the most common complication in 62 patients (54.4%). The prevalence of unnecessary cervical collaruse was 37.5% in female trauma patients and 43.88% in male trauma patients, which was not statisticallysignificant (p=0.63). The prevalence of unnecessary cervical collar use in trauma patients with multiple traumawas 39.42% and 80% in patients without multiple trauma, which was statistically significant (p=0.018). Patientswith a medical history had a higher rate of unnecessary use of the cervical collar (47.96%) than those withouta history (12.5%), and this difference was statistically significant (p=0.008).Conclusion: The guidelines for using cervical collars need to be updated by the EMS. Due to the large numberof trauma patients in Iran, cervical collars for necessary conditions can help to reduce the healthcare expensesand injuries caused by unnecessary cervical collars.
Original Article
zahra jalilian; Fathola Mohamadian; Yousef Veisani; Sasan Ahmadi
Articles in Press, Accepted Manuscript, Available Online from 30 October 2023
Abstract
Background: Suicide, Homicide and addiction is one of the public health problems. According to the report of the World Health Organization, thousands of people die every year due to social damage.This study aims to investigate the trend of mortality and YLL caused by social harm It was done in Ilam province,2009-2019.Methods:This ...
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Background: Suicide, Homicide and addiction is one of the public health problems. According to the report of the World Health Organization, thousands of people die every year due to social damage.This study aims to investigate the trend of mortality and YLL caused by social harm It was done in Ilam province,2009-2019.Methods:This cross-sectional study was conducted in Ilam province between 2009and 2019, and all deaths caused by suicide, Homicide, and addiction were included in the study to estimate YLL.The data were collected from the forensic organization. Analysis it was done using SPSS 23 software at 0.05 significant levels.Results: In total, 1712 cases of suicide, Homicide and addiction occurred between 2009 and 2019, which resulted in a total of (62,605) thousand years of lost life (53,934 per 100,000 people).And the highest frequency was related to the age group of 15-29 years and the lowest was related to the age group of 0-14 years (p<0.000). During the studied period, the rate of suicide, Homicide and addiction in Ilam was related to men (P>0.439).Suicide and Homicide in Ilam province during the years 2009 to 2019 for both genders have started a decreasing trend, and on the other hand, deaths caused by addiction are increasing.Conclusion: The results of this study showed that the age groups of 15-29 years had the highest rate of YLL caused by (suicide, Homicide and addiction) for both sexes. Also, the results of the research showed that YLL decreased for suicide and Homicide, but increased for addiction.
Original Article
Hedayat Jafari; Rahmatollah Marzband; Mahsa Kamali; Mahmood Moosazadeh; Pooyan Ghorbani Vajargah; Samad Karkhah; Joseph Osuji; Behzad Davaribina
Articles in Press, Accepted Manuscript, Available Online from 16 October 2023
Abstract
Background: Burnout is a form of physical, emotional, and mental fatigue following long-term hard work. This study assessed emergency nurses' spiritual well-being (SWB) and occupational burnout (OB) and examined the associations between these variables.Method: This cross-sectional study was conducted ...
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Background: Burnout is a form of physical, emotional, and mental fatigue following long-term hard work. This study assessed emergency nurses' spiritual well-being (SWB) and occupational burnout (OB) and examined the associations between these variables.Method: This cross-sectional study was conducted in six hospitals and emergency medical centres affiliated with Ardebil University of Medical Sciences in Ardebil province, Iran, in 2020. Data were collected via socio-demographic, Spiritual Well-Being Scale (SWBS), and Maslach Burnout Inventory (MBI) questionnaires.Results: A total of 239 emergency department nurses participated in this study. The mean age of participants was 34.4±6.4 years. The mean of existential well-being and religious well-being was 40.3±8.7 and 41.0±9.2, respectively. Findings suggest that personal accomplishment is a positive and significant predictor for the SWB of emergency department nurses (P<0.05).Conclusion: Proper planning and provision of suitable educational programs in the dimension of the SWB of nurses prevent the creation and continuation of OB and increase the self-efficacy and job satisfaction of emergency medical workers, leading to better service provision to patients.
Original Article
Mohammad Amin Mahdiyar; Mohammad Taghi Karimi; Hamid Namazi; Hussein Malekjamshidi
Articles in Press, Accepted Manuscript, Available Online from 14 November 2023
Abstract
Background: Although scapholunate dissociation is the most common etiology of carpal instability, the best surgical intervention to address this issue is not yet understood. The choice of operation is currently based on the surgeons’ skill and accessible equipment.Objective: In this study, we aimed ...
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Background: Although scapholunate dissociation is the most common etiology of carpal instability, the best surgical intervention to address this issue is not yet understood. The choice of operation is currently based on the surgeons’ skill and accessible equipment.Objective: In this study, we aimed to compare the results of scapholunate fixation using pins and screws in parallel, convergent, and divergent orientations.Methods and Materials: In this computer simulation study, the CT scan images of a normal subject were used to create a 3D model of the wrist joint by use of MIMICS software. The imposed force to scaphoid and 3D model lunate bones, and the scapholunate angle and distance were compared in different surgical approaches using parallel, divergent, and convergent pins and screws.Results: The imposed stress applied to the scaphoid and lunate bones in cases of parallel pins and screws were 7.5MPa, 5.08MPa (pins), 1.134MPa, and 1.151MPa (screws) in no external force condition and 10.90MPa, 10.90MPas (pins), 9.7MPa, and 34.1MPa (screws) for 50N flexion force. The imposed stress in this approach is significantly lower compared to other interventions. Better outcomes were seen regarding scapholunate angle and scapholunate distance in using parallel pins or screws as well. Conclusion: In conclusion implementing parallel pins and screws for scapholunate fixation had better results in achieving carpal stability in scapholunate dissociation; however fixation with pins and screws showed a statistically significant difference. Furthermore, range of motion exercises with no additional forces can be used in the rehabilitation of patients undergoing this surgery.
Case Report
Mohammad Sadegh Masoudi; Sina Zoghi; Adrina Habibzadeh; Reza Taheri; Ali Ansari
Articles in Press, Accepted Manuscript, Available Online from 30 October 2023
Abstract
Approaching posterior fossa pathologies is fairly challenging. Poor exposure, Cerebrospinal Fluid (CSF) leak following surgery, post-operative suboccipital and neck pain, and wound healing are common challenges following traditional suboccipital midline incision. Herein, we present a new incision for ...
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Approaching posterior fossa pathologies is fairly challenging. Poor exposure, Cerebrospinal Fluid (CSF) leak following surgery, post-operative suboccipital and neck pain, and wound healing are common challenges following traditional suboccipital midline incision. Herein, we present a new incision for approaching posterior fossa pathologies. The incision is shaped like a question mark and makes a musculofascial flap supplied by occipital artery on top of providing a wide area for craniotomy. In our technique, the dura is also incised in a question mark shaped manner. Three patients with masses in posterior fossa were operated with the new incision. Following surgeries, there were no adverse events including CSF leak, wound complications, severe suboccipital pain and neck instability in any of the patients. This new incision not only facilitates approaching to pathologies in posterior fossa with providing wider exposure, but also enables us for watertight Dural closure which decreases CSF leak. Also, as the muscular incision provides a sufficient area for craniotomy, muscular retraction can be minimized to avoid post-operative pain. Moreover, as opposed to the midline avascular incision, the flap is well supplied by occipital artery which facilitates the healing procedure.
Case Report
Majid Reza Farrokhi; Seyed Reza Mousavi; Mohammad Reza Tamjidi; Saeed Tayebi Khorami; Abbas Khosravi farsani; Jaloliddin Mavlonov; Hamid Jangi Aghdam; Armin Akbarzadeh
Articles in Press, Accepted Manuscript, Available Online from 08 October 2023
Abstract
Thoracic ossification of the posterior longitudinal ligament (OPLL) is a rare condition which mainly occurs accompanied by cervical OPLL or ossification of thoracic ligamentum flavum. OPLL is a disease with a variety of predisposing factors, including obesity. In case of causing neurological manifestations, ...
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Thoracic ossification of the posterior longitudinal ligament (OPLL) is a rare condition which mainly occurs accompanied by cervical OPLL or ossification of thoracic ligamentum flavum. OPLL is a disease with a variety of predisposing factors, including obesity. In case of causing neurological manifestations, it is preferred to treat the disease surgically. Several surgical methods were introduced through anterior, posterior, or combined approaches. Laminectomy with instrumented fusion is the most popular method utilized via the posterior approach. We report a 32-year-old obese woman who suffered from back pain and weakness in both lower extremities for one month referred to our spine outpatient clinic. Imaging showed lower thoracic OPLL (T7/T8 & T8/T9 & T9/T10). The ossification pattern of the posterior longitudinal ligament was mixed type (beaked and continued cylindrical). We performed laminectomy and long segment fixation (T7 to T12) to maintain the stability of the thoracic spine and prevent future kyphosis. Post-operative neurological examination showed improvement in the muscle power and significant pain relief.
Letter to the Editor
Mojtaba Heydari; Behnam Dalfardi; Mahdie Hajimonfarednejad; Mohammad Hashem Hashempur
Articles in Press, Accepted Manuscript, Available Online from 21 October 2023
Abstract
This paper offers a historical exploration of how death was diagnosed in Persian medicine, highlighting the evolution of diagnostic criteria and the contributions of key scholars. In the post-medieval era, defining death and establishing diagnostic criteria underwent significant development, albeit with ...
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This paper offers a historical exploration of how death was diagnosed in Persian medicine, highlighting the evolution of diagnostic criteria and the contributions of key scholars. In the post-medieval era, defining death and establishing diagnostic criteria underwent significant development, albeit with ongoing debates. Notably, medieval Persian scholars, such as Qutb al-Din al-Shirazi, played a crucial role in this discourse. Qutb al-Din al-Shirazi, a prominent Persian polymath, synthesized earlier knowledge to provide a comprehensive set of diagnostic criteria for death in traditional Persian medicine. These criteria encompassed physical examinations like assessing nail shininess, feeling pulsatile vessels in specific areas, observing pupillary reactions to light, and even monitoring the movement of a thread near the mouth and nose. His mention of the pupillary light reflex is one of the earliest known references to this phenomenon in medical history. Medieval Persian practices also involved placing a water container on the chest of the individual to detect the absence of chest wall motion associated with respiration as a sign of death. Furthermore, scholars like Ibn-e Sina (Avicenna) stressed the importance of monitoring pulse and respiration as vital signs, especially when administering potentially lethal drugs. In cases of uncertain diagnosis, such as stroke, medieval Persians postponed burials for up to three days. These historical insights provide a fascinating glimpse into the evolving understanding of death in Persian medicine and the intricate methods used for its diagnosis.
Letter to the Editor
Hossein Akbarialiabad; Rowena Christiansen; Mohsen Farjoud Kouhanjani; Milad Ahmadi Marzaleh; Mohammad Hossein Taghrir
Articles in Press, Accepted Manuscript, Available Online from 08 November 2023
Abstract
In a rapidly changing environment, healthcare systems in polar regions face increasing pressures imposed by climate change, burgeoning tourism, and potential ramifications for future space exploration. The urgency to reevaluate health stewardship and governance in these areas is driven by unique challenges, ...
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In a rapidly changing environment, healthcare systems in polar regions face increasing pressures imposed by climate change, burgeoning tourism, and potential ramifications for future space exploration. The urgency to reevaluate health stewardship and governance in these areas is driven by unique challenges, including geographical barriers and scarce resources. Further accentuated by the ongoing COVID-19 pandemic and the anticipated boom in the polar tourism industry, the need for robust emergency, trauma, and surgical care is highlighted. The objective of this paper is to address these challenges and advocate for a unified health governance approach. Adopting measures like artificial intelligence, telemedicine, and advanced technologies is suggested to promote the effectiveness of remote care, considering the distinct limitations of these regions. Moreover, research focused on the human health impact of these extreme conditions is paramount for formulating adequate responses, thereby improving the overall readiness and resilience of the healthcare systems in these regions.
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