Ramin Tajvidi; Golnar Sabetian; hossein abdolrahimzadeh fard
Volume 12, Issue 3 , July 2024, , Pages 142-145
Abstract
Bronchial rupture following major blunt chest trauma should be suspected in any case of massive and persistentair leak through the intercostal drain tube. Chest radiographs and chest computed tomography scans (CT scans)are highly suggestive of this extremely rare tracheobronchial injury. The present ...
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Bronchial rupture following major blunt chest trauma should be suspected in any case of massive and persistentair leak through the intercostal drain tube. Chest radiographs and chest computed tomography scans (CT scans)are highly suggestive of this extremely rare tracheobronchial injury. The present study reported a patient whowas a 15-year-old boy. He was a case of a motor-car accident and was brought to the emergency room (ER)of Rajaie Hospital ( Shiraz, Iran) due to dyspnea and chest pain. The physical examination revealed a fewcrash injuries on his upper extremities, as well as subcutaneous emphysema in his neck. The chest X-rayrevealed a right clavicular fracture, multiple rib fractures, a right pneumothorax (but no complete collapseor fallen lung), and also pneumo-mediastinum and subcutaneous emphysema. The chest CT revealed severepulmonary contusion, severe right-sided pneumothorax, significant pneumo-mediastinum, subcutaneousemphysema, multiple right-side rib fractures, and mild displacement of the right main bronchus. Furthermore,no definitive signs of bronchial rupture were detected. Using a mechanical ventilator, the following parameterswere revealed. The maximum pressure (Pmax)=7cm, H2o (was very low), plateau pressure (P. Plateau), andexpiratory tidal volume (TV) were not detected due to insufficient amounts. Additionally, increasing TV didnot change those values. Bronchial rupture is one of the most important and serious differential diagnoses inforceful chest traumas when the mechanical ventilator reveals low Pmax, very low P.platue, and expiratory TV,with no change in those values with increasing TV.
hossein abdolrahimzadeh fard; soheil bolandi; zahra mohammadi
Volume 11, Issue 3 , July 2023, , Pages 162-165
Abstract
Due to the specific features of the adrenal glands, traumatic adrenal injury is a rare phenomenon. Themajority of these rare types of traumas are caused by blunt force injuries and rarely by penetratingmechanisms. In such cases, a whole-body computed tomography scan is essential for early diagnosis.This ...
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Due to the specific features of the adrenal glands, traumatic adrenal injury is a rare phenomenon. Themajority of these rare types of traumas are caused by blunt force injuries and rarely by penetratingmechanisms. In such cases, a whole-body computed tomography scan is essential for early diagnosis.This paper describes an uncommon case of adrenal hematoma and contusion followed by blunt abdominaltrauma. A 35-year-old woman was admitted to the emergency department after a high-speed vehicle-pedestriancollision. She presented with decreasing level of consciousness. Additionally, a thoracoabdominal CT scanrevealed a left flank hematoma. Blunt adrenal injury, often accompanied by multiorgan damage, is a rareoccurrence resulting from severe accidents. Accurate diagnosis based on clinical symptoms requires highclinical suspicion, particularly in isolated cases, and treatment depends on the patient’s condition.
Golnar Sabetian; Hossein Abdolrahimzadeh fard; Mina Ostovan; Sina Azadikhah; Farid Zand; Mansoor Masjedi; Naeimehossadat Asmarian
Volume 10, Issue 4 , October 2022, , Pages 172-180
Abstract
Objective: To compare clinical and paraclinical similarities between trauma patients with positive RT-PCRtests (PCR+ve) and the RT-PCR negative ones (PCR -ve).Methods: This a case-control study, where cases had a PCR+ve and controls had a negative result. Two groupswere compared regarding (para) clinical ...
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Objective: To compare clinical and paraclinical similarities between trauma patients with positive RT-PCRtests (PCR+ve) and the RT-PCR negative ones (PCR -ve).Methods: This a case-control study, where cases had a PCR+ve and controls had a negative result. Two groupswere compared regarding (para) clinical values. Multivariable binary logistic regression analysis investigatedthe variables predicting COVID-19 and the mortality rate.Results: Both groups were similar regarding the clinical findings and comorbidities (p>0.05). PCR+ve grouphad lower lymphocyte count (1.41 [1.45] vs. 1.66 [1.61], p=0.030), CPK level (411 [928.75] vs. 778 [1946.5].p=0.006) and CRP level (17 [42.5] vs. 24 [50.75], p=0.004). However, none of these findings were significant inthe multivariable analysis. Finally, PCR+ve group had increased odds of death (OR=2.88; 95% CI=1.22-7.41).Conclusion: Unlike our primary hypothesis, the study failed to mark any significant (para) clinical featuresguiding us to detect COVID-19 earlier in trauma patients. Moreover, the PCR+ve group is at increased mortalityrisk. A larger, multicentric prospective study should be designed to address this issue.
Hossein Abdolrahimzadeh fard; Roham Borazjani; Amir Hossein Shams; Vala Rezaee; Shiva Aminnia; Maryam Salimi; Mahsa Ahadi; Shahram Paydar; Shahram Bolandparvaz; Nikta Rabiei; Sanaz Zare; Leila Shayan; Mina Sadeghi
Volume 10, Issue 3 , July 2022, , Pages 128-134
Abstract
Objective: To evaluate the presence/severity of depression, anxiety, and stress among health care workers(HCWs) who work on the specially allocated COVID-19 ward (Group A) and HCWs on the other wards(Group B).Methods: This questionnaire-based study was conducted from January 25 to February 28, 2021. ...
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Objective: To evaluate the presence/severity of depression, anxiety, and stress among health care workers(HCWs) who work on the specially allocated COVID-19 ward (Group A) and HCWs on the other wards(Group B).Methods: This questionnaire-based study was conducted from January 25 to February 28, 2021. The mentalstatus was assessed using the Persian version of the 42-item Depression, Anxiety, and Stress score (DASS-42).Gathered data was analyzed using SPSS version 25. The independent T-test and Chi-square tests were used tocompare quantitative and qualitative variables.Results: Two-hundred and twenty two questionnaires were eligible for analysis. Group A consisted of 33HCWs, and 189 (85.1%) individuals were working on the other wards. No statistically significant differenceswere seen regarding the Socio-demographic features except for the marital status (p=0.005). The depressions’mean score was comparable between group A and B (p=0.102). The mean scores of anxiety and stress weresignificantly lower in group A than group B (p=0.006), although the frequency of DASS-42 parameters did notdiffer between these two groups (p>0.05).Conclusion: Contrary to our assumptions, this study showed that the DASS-42 parameters were not higher inHCWs working on the COVID-19 wards. This might be justified by developing coping mechanisms, being onthe honeymoon phase of the disaster, compassion satisfaction, promising vaccine news, and working on theless impacted hospital.
Hossein Akbarialiabad; Hossein Aabdolrahimzadeh fard; Hamid Reza Abbasi; Shahram Bolandparvaz; Shahin Mohseni; Vahid Mehrnoush; Mina Salehi; Sima Roushenas; Shahram Paydar
Volume 8, Issue 3 , July 2020, , Pages 199-201
Abstract
During the past few months, the novel coronavirus 2019 (COVID-19) pandemic has significantly affected medical service provision. In Iran, it has caused around 197,000 inflictions and 9200 deaths up to June 18, 2020. While many departments turned to telehealth in this era, the trauma service should provide ...
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During the past few months, the novel coronavirus 2019 (COVID-19) pandemic has significantly affected medical service provision. In Iran, it has caused around 197,000 inflictions and 9200 deaths up to June 18, 2020. While many departments turned to telehealth in this era, the trauma service should provide non-stop in presence service to the trauma victims. Our trauma center is the largest in the southwest of Iran, with the mean annual admission of 18,500 polytrauma patients. In this center, we designed a safety protocol to mitigate the spread of disease and also have a more robust case finding system, especially among asymptomatic carriers who attend hospitals based on their trauma. In brief, all unstable patients were considered SARS-COV-2 positive and were directed toward the Specialized COVID-19 related ICU. For all stable patients, history, physical examination, CXR, and lab test (Complete Blood Count, Erythrocyte Sedimentation Rate, C-Reactive Protein) were ordered before entering the wards. If there was any suspicion of COVID-19, the stable patient was admitted to the COVID-19 specialized ward. Among all 1805 patients admitted during a ten weeks interval (from January 30, 2020, to April 14, 2020), 84 had a red flag and toward to COVID-19 related wards. Of those, 67 had positive PCR or evidence in CT in favor of the COOVID-19. Moreover, during regular workups, we found that 19 completely asymptomatic trauma victims had typical Chest CT scan findings of COVID-19.