Keyvan Eghbal; Abbas Rakhsha; Arash Saffarrian; Abdolkarim Rahmanian; Hamid Reza Abdollahpour; Fariborz Ghaffarpasand
Volume 6, Issue 4 , October 2018, , Pages 367-371
Abstract
Atlantoaxial rotatory subluxation (AARS) is rarely occurred in adults with trauma as the most common cause. In type A and B it is usually managed with close reduction and external brace; however, in nonresponsive cases, surgical interventions might be needed. Our patient is a 21-year-old man with neck ...
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Atlantoaxial rotatory subluxation (AARS) is rarely occurred in adults with trauma as the most common cause. In type A and B it is usually managed with close reduction and external brace; however, in nonresponsive cases, surgical interventions might be needed. Our patient is a 21-year-old man with neck pain and torticollis after a car turn- over. There was C1-C2 rotatory subluxation with left side locked facet and C1 rotation about 40 degrees relative to C2 on computed tomography without evident of ligamentous injury in magnetic resonance imaging (MRI). However, during the first 48 hours, two tries of close reduction using Gardner cervical traction under fluoroscopy were failed. Thus, the patient underwent open reduction of the subluxation and atlantoaxial fixation (Harm’s technique) with subsequent relief of pain and torticollis. This a rare case of traumatic AARS type A with unilateral locked facet joint in an adult patient which needed surgical manipulation for reduction. The management of the AARS in adults should be individualized in each patient.
Steven Liu; Quinn Fujii; Farris Serio; Andrew McCague
Volume 6, Issue 3 , July 2018, , Pages 217-220
Abstract
Objective: To determine if there exists an upper limit for amount of blood transfused in trauma patients before it reaches a point of futility.Methods: A prospective cohort study was conducted on 131 patients who received massive blood transfusion (MBT), defined as 10 U or higher of PRBCs received in ...
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Objective: To determine if there exists an upper limit for amount of blood transfused in trauma patients before it reaches a point of futility.Methods: A prospective cohort study was conducted on 131 patients who received massive blood transfusion (MBT), defined as 10 U or higher of PRBCs received in the initial 24 hours. Data collected from a Level II trauma center registry were used to analyze reports of adult patients from July 2014 to 2017. Cohorts were divided by amount of blood received - 0 to 9 U, 10-19 U, 20 to 29 U, 30-39 U, 40 U or higher - odds ratio for mortality and p-values for mean Injury Severity Score and overall hospital length of stay were calculated for each group.Results: Odds ratios for massive blood transfusion groups from 10 units to 39 units each contained the null value, while our 40 units and above group did not (OR 12.52, 95% CI 1.3-117.7).Conclusion: Although this study is limited by its sample size, these results suggests that 40 units of PRBCs may be a threshold at which survival rates begin to decrease significantly.
Mohamadreza Saatian; Jamal Ahmadpoor; Younes Mohammadi; Ehsan Mazloumi
Volume 6, Issue 1 , January 2018, , Pages 45-53
Abstract
Objective: To determine the epidemiological aspects of patients with traumatic brain injury (TBI) in a regional trauma center.Methods: A cross-sectional study was conducted on patients with TBI during 2013 to 2016 in a single center in Hamedan, central Iran. The distribution and relationships of TBI ...
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Objective: To determine the epidemiological aspects of patients with traumatic brain injury (TBI) in a regional trauma center.Methods: A cross-sectional study was conducted on patients with TBI during 2013 to 2016 in a single center in Hamedan, central Iran. The distribution and relationships of TBI was assessed with gender, age, type of trauma, traumatic cause, exiting status and Length of Hospitalization (LOH). Data were analyzed by Stata V11 statistical software.Results: In general, 9426 patients with TBI were enrolled in analyses. The mean ± SD age of patients was 29.70 (± 21.46) years. Multivariate logistic regression indicated that being male [OR: 1.29; 95% CI (2.92-4.73), P ≤0.001], 41-50 to 71-80 and 90+ years old' age groups (1.32<OR<3.12, 0.029<p≤0.001), having surgery [OR: 5.58; 95% CI (4.89-6.37), p≤0.001], and different types of trauma (p≤0.001) were significantly related to LOH. Moreover, odds ratio of mortality was 1.52 times greater in males than females (p≤0.001). As the age increases, the odds ratio of mortality was also rising. However, having surgery [OR: 3.72; 95% CI (2.92-4.73), p≤0.001], LOH >5 days [OR: 2.01; 95% CI (1.60-2.52), p≤0.001] and different types of trauma were significantly related to mortality.Conclusion: TBI is one of the main causes of mortality and LOH of the young population. By providing preventive measures and a traumatic care system, the burden of trauma can be greatly reduced, the implementation of the trauma care system in Hamedan province is a necessity.
Nurettin Aktas; Umut Gulacti; Ugur Lok; Irfan Aydin; Tayfun Borta; Murat Celik
Volume 6, Issue 1 , January 2018, , Pages 64-70
Abstract
Objective: To identify errors in forensic reports and to describe the characteristics of traumatic medico-legal cases presenting to the emergency department (ED) at a tertiary care hospital.Methods: This study is a retrospective cross-sectional study. The study includes cases resulting in a forensic ...
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Objective: To identify errors in forensic reports and to describe the characteristics of traumatic medico-legal cases presenting to the emergency department (ED) at a tertiary care hospital.Methods: This study is a retrospective cross-sectional study. The study includes cases resulting in a forensic report among all traumatic patients presenting to the ED of Adiyaman University Training and Research Hospital, Adiyaman, Turkey during a 1-year period. We recorded the demographic characteristics of all the cases, time of presentation to the ED, traumatic characteristics of medico-legal cases, forms of suicide attempt, suspected poisonous substance exposure, the result of follow-up and the type of forensic report.Results: A total of 4300 traumatic medico-legal cases were included in the study and 72% of these cases were male. Traumatic medico-legal cases occurred at the greatest frequency in July (10.1%) and 28.9% of all cases occurred in summer. The most frequent causes of traumatic medico-legal cases in the ED were traffic accidents (43.4%), violent crime (30.5%), and suicide attempt (7.2%). The most common method of attempted suicide was drug intake (86.4%). 12.3% of traumatic medico-legal cases were hospitalized and 24.2% of those hospitalized were admitted to the orthopedics service. The most common error in forensic reports was the incomplete recording of the patient's “cooperation” status (82.7%). Additionally, external traumatic lesions were not defined in 62.4% of forensic reports.Conclusion: The majority of traumatic medico-legal cases were male age 18-44 years, the most common source of trauma was traffic accidents and in the summer months. When writing a forensic report, emergency physicians made mistakes in noting physical examination findings and identifying external traumatic lesions. Physicians should make sure that the traumatic medico-legal patients they treat have adequate documentation for reference during legal proceedings. The legal duties and responsibilities of physicians should be emphasized with in-service training.
Pankaj Sharma; Nishank Mehta; Amit Narayan
Volume 5, Issue 4 , October 2017, , Pages 307-310
Abstract
Isolated traumatic brachialis muscle tears are uncommonly reported – leading to occasional misdiagnosis and misdirected treatment. The rarity of brachialis muscle tear may promote misdiagnosis or mistreatment of this injury. We report an isolated brachialis muscle tear in a young female, possibly ...
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Isolated traumatic brachialis muscle tears are uncommonly reported – leading to occasional misdiagnosis and misdirected treatment. The rarity of brachialis muscle tear may promote misdiagnosis or mistreatment of this injury. We report an isolated brachialis muscle tear in a young female, possibly caused by strenuous exercise in the gymnasium. The diagnosis was made clinically and confirmed by magnetic resonance imaging. The patient was subsequently managed adequately with conservative treatment. We herein present a 35-year-old woman who was diagnosed with an acute brachialis muscle tear being diagnosed with a combination of clinical signs and imaging and successfully managed non-operatively. A chronologically arranged review of literature is also presented.
Shahram Paydar; Mohammad Yasin Karami; Hosseinali Khalili; Maryam Dehghankhalili; Golnar Sabetian; Fariborz Ghaffarpasand
Volume 5, Issue 3 , July 2017, , Pages 141-142
Richa Aggarwal; Anudeep Saxena; Kapil Soni
Volume 5, Issue 3 , July 2017, , Pages 215-218
Abstract
Posterior reversible encephalopathy syndrome (PRES) is a rare clinicoradiological entity characterized by neurological symptoms. It is associated with various conditions like hypertension, renal diseases and use of cytotoxic agents. It occurs more often in adults than children. PRES has been described ...
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Posterior reversible encephalopathy syndrome (PRES) is a rare clinicoradiological entity characterized by neurological symptoms. It is associated with various conditions like hypertension, renal diseases and use of cytotoxic agents. It occurs more often in adults than children. PRES has been described in pediatric patient with renal diseases like nephrotic syndrome, nephritis and in acute renal failure as in cases of Hemolytic-uremic syndrome but there are no reports of PRES in cases of recovery from acute kidney injury due to prerenal cause like hypovolemia. We herein present an interesting case of 6-year-old girl with traumatic amputation who developed PRES days after recovery of acute kidney injury. The patient was successfully managed medically. The presented clinical scenario demonstrates the fact that PRES can develop in a trauma patient in acute setting of recovering from hypovolemic acute kidney injury. Prompt recognition and treatment is important and can lead to complete recovery.
Mehrzad Banihashemi; Azam Safari; Navid Nezafat; Mahmoodreza Tahamtan; Manica Negahdaripour; Negar Azarpira; Younes Ghasemi
Volume 5, Issue 1 , January 2017, , Pages 18-23
Abstract
Objective: To evaluate the effect of fibrin perihepatic packing on controlling liver hemorrhage and liver wound healing.Methods: In this animal experimental study, 20 adult male Sprague Dawley rats, weighing 200-220 g, were included. Stab wound injury was created by number 15 scalpel, so that bilateral ...
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Objective: To evaluate the effect of fibrin perihepatic packing on controlling liver hemorrhage and liver wound healing.Methods: In this animal experimental study, 20 adult male Sprague Dawley rats, weighing 200-220 g, were included. Stab wound injury was created by number 15 scalpel, so that bilateral liver capsules and liver tissue were cut, and acute bleeding was accrued. The animals were divided into 2 study groups: control (with a primary gauze packing treatment) and test group (with fibrin packing treatment). Serum alanine aminotransferase (ALT), aspartate aminotransferase (AST), and total serum bilirubin (TSB) levels were measured as a liver function test during the treatment period. Blood loss was calculated for estimation of hepatic hemorrhage during surgery. After four weeks, the liver wound repair was evaluated by sampling and Hematoxylin and Eosin staining (H&E).Results: In the test group, all of animals were alive (mortality rate= 0%). Significantly, ALT and AST levels were raised after surgery, followed by a decrease ALT (p=0.783) and AST (p=0.947) to the normal level during 4 days. Estimated blood loss was 2.89 ± 0.73 mL (about 19.65% of estimated blood volume). Hematocrit levels returned to the normal level (p=0.109) after 48 hours. In the control group, the mortality rate was 50% during 12h after surgery. ALT (p=0.773) and AST (p=0.853) were decreased to normal level during 6 days, and estimated blood loss was 4.98 ± 0.77 mL (about 32.98% of estimated blood volume) in the remaining animals. Moreover, hematocrit levels returned to the normal level (p=0.432) after 72 hours. Estimated blood loss in the test group was significantly less than control group (p<0.001). Total serum bilirubin levels were not significantly different from the normal level, before and after surgery in both groups. Histopathology sections from the post-hepatectomy specimens showed that the site of the previous incision was completely repaired, and a dense fibrous septum was observed in both groups.Conclusion: The fibrin dressing was effective in preventing blood loss and saving lives after a liver stab injury and major internal bleeding in the animal model of rat.
Marjan Jeddi; Mohammad Hossein Dabbaghmanesh; Alireza Kharmandar; Gholamhossein Ranjbar Omrani; Marzieh Bakhshayeshkaram
Volume 5, Issue 1 , January 2017, , Pages 29-35
Abstract
Objective: To determine the prevalence of fractures and associated risk factors in healthy Iranian children and adolescents.Methods: In this cross sectional population based study, 478 healthy Iranian children and adolescents aged 9–18 years old participated. Baseline data and bone mineral content ...
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Objective: To determine the prevalence of fractures and associated risk factors in healthy Iranian children and adolescents.Methods: In this cross sectional population based study, 478 healthy Iranian children and adolescents aged 9–18 years old participated. Baseline data and bone mineral content and density have been determined. One questionnaire was completed for all individuals including previous history of fracture, its location, and level of trauma. Albumin, calcium, phosphorus, alkaline phosphatase, and vitamin D levels were measured.Results: We found a prevalence of 12.9% for fracture. (34.5% for girls and 65.5% for boys); about 71% suffered long bone fracture with distal forearm as the most common site. Totally 58% of the boys and 54% of the girls had fracture with low-energy trauma. The fracture group had lower bone mineral apparent density in the lumbar spine (0.19±0.04 vs. 0.20±0.03, p=0.04), lower serum albumin (4.6±0.5 vs 4.8±0.4, p=0.02), and higher serum alkaline phosphatase level (446±174 vs. 361±188, p=0.02) compared with non-fracture subjects. By logistic regression analysis, we found a significant association for sex, and bone mineral content of the lumbar spine with fracture (p=0.003, p=0.039).Conclusion: Compared to other studies, our subjects had lower rate of fracture. We found an association between low bone density and fracture in children and adolescents. This finding has important implications for public health. Further research may contribute to recognition of preventive measures.
Amir Khorram-Manesh
Volume 4, Issue 4 , October 2016, , Pages 183-185
Zahra Mohtasham-Amiri; Saeed Dastgiri; Ali Davoudi-kiakalyeh; Ali Imani; Keyvan Mollarahimi
Volume 4, Issue 4 , October 2016, , Pages 230-235
Abstract
Objective: To determine the epidemiological characteristics of the road traffic injuries (RTIs) in Guilan province, northern Iran.Methods: This study was a cross-sectional study which included all of RTIs admitted to medical centers of Guilan province (northern Iran) during 2012. ICD-10 was used as ...
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Objective: To determine the epidemiological characteristics of the road traffic injuries (RTIs) in Guilan province, northern Iran.Methods: This study was a cross-sectional study which included all of RTIs admitted to medical centers of Guilan province (northern Iran) during 2012. ICD-10 was used as diagnostic criteria. Demographic variables also injury circumstance and in hospital variables such as length of stay, time of admission, type of surgery, ICU admission, final outcome and mechanism of injury, anatomical part of injury according to Abbreviated Injury Scale (AIS) classification were derives from records by trained research team. Descriptive data is reported. The predictors of mortality were also determined.Results: The prevalence of road traffic injuries in Guilan province was 31 in 10,000 populations. Of total 7671 accidents, 5976 (77.9%) were men and 1695 (22.1%) were women. Mean age of these victims was 33.3 ± 17.289 years (32.64±16.939 for men, 35.62±18.312 for women). Most of them (32.5%) were 20-29 years old. Motorcycle-car accidents had the highest frequency followed by car-car crashes and car accidents involving pedestrians. Most of the patients (85.9%) were hospitalized and 280 injured died (3.7%). Upper extremities were the most sites of injuries. Male sex, length of hospital stay, multiple injuries and increased age were associated with road traffic accident associated mortality.Conclusion: RTIs cause enormous death and disability in this area and more road traffic preventive programs should be enforcement in these areas to reduce incidences RTI.
Shahram Paydar; Golnar Sabetian; Hosseinali Khalili; Hamid Reza Abbasi; Shahram Bolandparvaz; Zahra Ghahramani; Behnam Dalfardi; Donat R. Spahn
Volume 4, Issue 3 , July 2016, , Pages 121-123
Hamid Reza Abbasi; Mitra Amini; Shahram Bolandparvaz; Shahram Paydar; Jameel Ali; Sepideh Sefidbakht
Volume 4, Issue 2 , April 2016, , Pages 75-79
Abstract
Objective: To evaluate the effect of advance trauma life support (ATLS®) training on general surgery residents clinical reasoning skills using the national boards-style objective structured clinical examination (OSCE).Methods: This cross-sectional single-center study was conducted in Shiraz University ...
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Objective: To evaluate the effect of advance trauma life support (ATLS®) training on general surgery residents clinical reasoning skills using the national boards-style objective structured clinical examination (OSCE).Methods: This cross-sectional single-center study was conducted in Shiraz University of Medical Sciences including 51 surgery residents that participated in a mandatory national board style OSCE between May 2014 and May 2015. OSCE scores of two groups of general surgery residents including 23 ATLS® trained and 28 non-ATLS® trained were compared using Mann-Whitney U test. The exam was graded out of 20 points and the passing score was ≥14 including 40% trauma cases.Results: There were 8(15.7%) women and 43(84.3%) men among the participants with mean age of 31.12 ± 2.69 and 33.67 ± 4.39 years in women and men respectively. Overall 7 (87.5%) women and 34 (79.07%) men passed the OSCE. The trauma section OSCE score was significantly higher in the ATLS® trained participants when compared to non-ATLS®(7.79 ± 0.81vs.6.90 ± 1.00; p=0.001). In addition, the total score was also significantly higher in ATLS® trained residents (16.07 ± 1.41 vs. 14.60 ± 1.40; p=0.001). There was no association between gender and ATLS® score (p=0.245) or passing the OSCE (p=0.503).Conclusion: ATLS® training is associated with improved overall OSCE scores of general surgery residents completing the board examinations suggesting a positive transfer of ATLS learned skills to management of simulated surgical patients including trauma cases.
Behnaz Poorian; Mehdi Bemanali; Mohammad Chavoshinejad
Volume 4, Issue 2 , April 2016, , Pages 88-92
Abstract
Objective: To evaluate sensorimotor nerve damage in patients with maxillofacial trauma referring to Taleghani hospital, Tehran, IranMethods: This cross-sectional study was conducted during a 2-year period from 2014 to 2012 in Taleghani hospital of Tehran. We included a total number of 495 patients with ...
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Objective: To evaluate sensorimotor nerve damage in patients with maxillofacial trauma referring to Taleghani hospital, Tehran, IranMethods: This cross-sectional study was conducted during a 2-year period from 2014 to 2012 in Taleghani hospital of Tehran. We included a total number of 495 patients with maxillofacial trauma referring to our center during the study period. The demographic information, type of fracture, location of fracture and nerve injuries were assessed and recorded in each patients. The frequency of sensorimotor injuries in these patients was recorded. Data are presented as frequencies and proportions as appropriate.Results: Overall we included 495 patients with maxillofacial trauma with mean age of 31.5±13.8 years. There were 430 (86.9% men and in 65 (13.1%) women among the patients. The frequency of nerve injuries was 67.7% (336 patients). The mean age of the patients with nerve injuries was 33.4 ± 3.7 years. Marginal mandibular branch of facial nerve was the most common involved nerve being involved in 5 patients (1%). Regarding trigeminal nerve, the inferior alveolar branch (194 patients 39.1%) was the most common involved branch followed by infraorbital branch (135 patients 27.2%). Mandibular fracture was the most common injured bone being reported in 376 patient (75.9%) patients followed by zygomatic bone in 100 patient (20%).Conclusion: The most frequent fracture occurred in mandible followed by zygoma and the most injured nerve was inferior alveolar nerve followed by infraorbital branch of trigeminal nerve. In facial nerve the marginal branch was the most involved nerve. The frequency of nerve injury and the male to female ratio was higher in the current study compared to the literature.
Maarten Philip Cornelissen; Jesse van Buijtenen; Baukje van den Heuvel; Frank Bloemers; Leo Geeraedts Jr.
Volume 4, Issue 2 , April 2016, , Pages 105-109
Abstract
With the introduction of the use of seatbelts in cars, mortality following motor vehicle crashes has decreased significantly. However, two patterns of injuries, the ‘seatbelt sign’ and ‘seatbelt syndrome’ have emerged. Injuries may consist of traumatic abdominal wall disruption. We present two ...
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With the introduction of the use of seatbelts in cars, mortality following motor vehicle crashes has decreased significantly. However, two patterns of injuries, the ‘seatbelt sign’ and ‘seatbelt syndrome’ have emerged. Injuries may consist of traumatic abdominal wall disruption. We present two cases of severe abdominal wall disruption caused by a seatbelt injury and treated with primary repair. A review of the literature is provided. Two patients were brought in after a high velocity Motor Vehicle Collision. Both presented with an acute abdomen and a seatbelt sign upon which the decision was made to perform emergency laparotomies. Both patients had an abdominal wall disruption along the seatbelt sign. These disruptions were primarily closed and during six months of follow-up no complications occurred. A disruption of the abdominal wall is a rare complication. However, it is a diagnosis that may not be missed as patients have a higher risk of morbidity and mortality. CT-scanning is an accurate method to detect disruptions. Closure of blunt traumatic abdominal wall disruption can be done primarily with sutures or addition of a mesh. In both cases of the severe abdominal wall disruption, primary repair without mesh in the acute phase was successful. When a laparotomy is not indicated, the abdominal wall must be assessed for disruption. If there is a disruption primary repair is a good option.
Shahram Paydar; Golnar Sabetian; Hosseinali Khalili; Javad Fallahi; Mohammad Tahami; Bizhan Ziaian; Hamid Reza Abbasi; Shahram Bolandparvaz; Fariborz Ghaffarpasand; Zahra Ghahramani
Volume 4, Issue 1 , January 2016, , Pages 1-7
Abstract
Deep vein thrombosis (DVT) and pulmonary embolism (PTE) are known as venous thromboembolism (VTE). DVT occurs when a thrombus (a blood clot) forms in deep veins of the body, usually in the lower extremities. It can cause swelling or leg pain, but sometimes may occur with no symptoms. Awareness of DVT ...
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Deep vein thrombosis (DVT) and pulmonary embolism (PTE) are known as venous thromboembolism (VTE). DVT occurs when a thrombus (a blood clot) forms in deep veins of the body, usually in the lower extremities. It can cause swelling or leg pain, but sometimes may occur with no symptoms. Awareness of DVT is the best way to prevent the VTE. Patients with trauma are at increased risk of DVT and subsequent PE because of coagulopathy in patients with multiple trauma, DVT prophylaxis is essential but the VTE prophylaxis strategy is controversial for the trauma patients. The risk factors for VTE includes pelvic and lower extremity fractures, and head injury.
Luis Rafael Moscote-Salazar; Andres M. Rubiano; Hernando Raphael Alvis-Miranda; Willem Calderon-Miranda; Gabriel Alcala-Cerra; Marco Antonio Blancas Rivera; Amit Agrawal
Volume 4, Issue 1 , January 2016, , Pages 8-23
Abstract
Traumatic brain injury is a leading cause of death in developed countries. It is estimated that only in the United States about 100,000 people die annually in parallel among the survivors there is a significant number of people with disabilities with significant costs for the health system. It has been ...
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Traumatic brain injury is a leading cause of death in developed countries. It is estimated that only in the United States about 100,000 people die annually in parallel among the survivors there is a significant number of people with disabilities with significant costs for the health system. It has been determined that after moderate and severe traumatic injury, brain parenchyma is affected by more than 55% of cases. Head trauma management is critical is the emergency services worldwide. We present a review of the literature regarding the prehospital care, surgical management and intensive care monitoring of the patients with severe cranioecephalic trauma.
Endre Varga; Endre Csonka; Balázs Kószó; Zoltán Pető; Zsuzsanna Ágoston; Erika Gyura; Gábor Nardai; Kristóf Boa; Gábor Süveges
Volume 4, Issue 1 , January 2016, , Pages 48-50
Abstract
Advanced Trauma Life Support (ATLS) programs are recognized as the standard educational trauma program worldwide. Data suggest that ATLS has a positive impact on the value of trauma care. The ATLS Hungary program has been started in 2005, celebrating its 10-year anniversary this year. In the present ...
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Advanced Trauma Life Support (ATLS) programs are recognized as the standard educational trauma program worldwide. Data suggest that ATLS has a positive impact on the value of trauma care. The ATLS Hungary program has been started in 2005, celebrating its 10-year anniversary this year. In the present brief communication a brief overview is provided on the program.Student evaluation and statistical data about the participants were collected throughout the 10-year history of the Hungarian program.Student evaluation shows a high level of satisfaction amongst the participating doctors. Most participants are working in higher level centers. The Hungarian program shows good quality according to the participants. Establishing at least one new center is crucial to be able to provide the course for every professional interested in it or required to take it.
Amir Khorram-Manesh
Volume 3, Issue 4 , October 2015, , Pages 115-117
Shahram Paydar; Golnar Sabetian; Zahra Ghahramani; Seyed Mohsen Mousavi; Hosseinali Khalili; Hamid Reza Abbasi; Shahram Bolandparvaz
Volume 3, Issue 4 , October 2015, , Pages 118-121
Mohammad Babaei; Gholamreza Najafi; Ali Shalizar Jalali; Mehdi Behfar
Volume 3, Issue 4 , October 2015, , Pages 122-127
Abstract
Objective: To determine bilateral effects of unilateral iatrogenic vas deferens trauma (UIT) on epididymal sperm characteristics and in vitro fertilizing capacity in an experimental mouse model.Methods: Experiments were performed on three equal groups each comprising six adult male mice. Following anaesthesia, ...
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Objective: To determine bilateral effects of unilateral iatrogenic vas deferens trauma (UIT) on epididymal sperm characteristics and in vitro fertilizing capacity in an experimental mouse model.Methods: Experiments were performed on three equal groups each comprising six adult male mice. Following anaesthesia, UIT was induced by clamping left vas deferens with a mosquito clamp in fully locked fashion for 2 minutes in UIT group. Control-sham mice only had exposure of the left vas deferens through a groin incision. Control animals only received ceftriaxone (100 mg/kg) intraperitoneally at the day of experimental UIT induction. Ipsilateral and contralateral epididymal sperm characteristics and in vitro fertilizing capacity were evaluated after 35 days.Results: UIT significantly decreased sperm concentration, motility and viability as well as fertilization, two-cell embryos, blastocysts and hatched blastocysts rates. Moreover, incidence of DNA damage and abnormality in spermatozoa was significantly higher in UIT group.Conclusion: The findings suggest that a non-recognized iatrogenic vas deferens trauma may have detrimental effects on spermatozoa leading to infertility.
Seyed Reza Modarres; Mohammad Hossein Shokrollahi; Mohsen Yaserian; Maryam Rahimi; Neda Amani; Ali Asghar Manouchehri
Volume 2, Issue 4 , October 2014, , Pages 146-150
Abstract
Objective: To determine the epidemiological characteristics of fatal traumatic accidents in patients referred to a hospital in Babol, Northern Iran.Methods: Thiswas a cross-sectionalstudy being performed during a 1-year period including all the dead trauma patients referred to ShahidBeheshtiHospital ...
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Objective: To determine the epidemiological characteristics of fatal traumatic accidents in patients referred to a hospital in Babol, Northern Iran.Methods: Thiswas a cross-sectionalstudy being performed during a 1-year period including all the dead trauma patients referred to ShahidBeheshtiHospital of Babol. We included all those patients who were transferred to our center to trauma and injuries and passed away during the hospital stay. Those who dieddue toelectrical shock, drowningandsuffocationcaused byhangingsandpoisoningwereexcluded from the study.Demographic information such as age, sex, marital status, education, employment, the type, location, and time of injury, injured parts of body and treatment methods, the cause, location and time of death were recorded.Results: From the 92 dead patients, 76were men(82.6%) and16were women (17.4%). The cause of deathin 53 cases (57.6%) washead injury. Regarding the location,30patients (32.6%) diedat thesceneof the accident,62(67.4%) diedin the hospital. The maximum rateof trauma occurredin the afternoon shiftbetween the hours of13:30 to 19:30.The headand facewere themost damaged organs.Road traffic accidents were the most common cause of injury related mortality recordedin 81 patients (88.0%). Most of the accidentsoccurredinintercity roads in 27 people (33.3%) and the others inrural-urbanroads. Pedestrianswere the most common victims of road traffic accidents mortality being reported in 29 people (35.8%).Conclusion: Road traffic accidents are among the most common cause of injury related mortality in our region. Increasing the public knowledge and improve the traffic law enforcement measures should be considered for decreasing the morbidity and mortality.
Shahram Paydar; Mojtaba Mahmoodi; Mohammad Jamshidi; Hadi Niakan; Mohammad Keshavarz; Nader Moeenvaziri; Mohammad Esmaeil Ghorbaninejad; Farnaz Farrokhnia; Forough Izadi Fard; Zahra Jaafari; Yalda Golshan; Hamidreza Abbasi; Shahram Bolandparvaz; Behnam Honarvar
Volume 2, Issue 3 , July 2014, , Pages 103-109
Abstract
Objective: To explore the pros and cons of early versus delayed intervention when dealing with severe blunt liver injury with significant hemoperitoneum and hemodynamic instability.Methods: This retrospective cross-sectional study was performed at the Nemazi hospital, Shiraz, Southern Iran, level I trauma ...
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Objective: To explore the pros and cons of early versus delayed intervention when dealing with severe blunt liver injury with significant hemoperitoneum and hemodynamic instability.Methods: This retrospective cross-sectional study was performed at the Nemazi hospital, Shiraz, Southern Iran, level I trauma Center affiliated with Shiraz University of Medical Sciences. The study population comprised of all patients who were operated with the impression of blunt abdominal trauma and confirmed diagnosis of liver trauma during an 8-year period. All data were extracted from patients’ hospital medical records during the study period. The patients’ outcome was compared between those who underwent perihepatic packing or primary surgical repair.Results: Medical records of 76 patients with blunt abdominal liver trauma who underwent surgical intervention were evaluated. Perihepatic packing was performed more in patients who have been transferred to operation room due to unstable hemodynamics (p<0.001) as well as in patients with more than 1000 milliliters of hemoperitoneum based on pre-operative imaging studies (e.g. CT/US) (p=0.002).Conclusion: We recommend that trauma surgeons should approach perihepatic packing earlier in patients who have been developed at least two of these three criteria; unstable hemodynamics, more than 1000 milliliters hemoperitoneum and more than 1600 milliliters of intra-operative estimated blood loss. We believe that considering these criteria will help trauma surgeons to diagnose and treat high risk patients in time so significant hemorrhage (e.g. caused by dilatational coagulopathy, hypothermia and acidosis, etc.) can ultimately be prevented and more lives can be saved.
Hassan Ravari; Masoud Pezeshki Rad; Aria Bahadori; Orkideh Ajami
Volume 2, Issue 2 , April 2014, , Pages 72-76
Abstract
ABSTRACTObjective: To compare the conventional angiographic findings in extremity trauma patients with or without runoff. Methods: This was cross-sectional study including all the patients with extremity trauma who underwent conventional angiography during the ...
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ABSTRACTObjective: To compare the conventional angiographic findings in extremity trauma patients with or without runoff. Methods: This was cross-sectional study including all the patients with extremity trauma who underwent conventional angiography during the 2 year period from 2011 to 2013 in Angiography departments of Mashhad University of Medical Sciences. Mechanism of trauma, type of injury and angiographic findings were recorded in a questionnaire for each patient. After completion of treatment and discharge, the treatment type was added. The characteristics as well as clinical findings were compared between those who were diagnosed to have arterial runoff ad those who did not.Results: One hundred and forty eight traumatic patients including 15 female with age range of 11-82 years and 133 men ranging from 25 to 40 years were enrolled. Abnormal angiographic findings were provided in 99 (66.9%) patients including cutoff with distal runoff (n=60, 60.6% of abnormalities), cut off without distal runoff (n=21,21.2%) and spasm (n=14, 14.1%) and other findings (n=4, 4%). Fifty one cases were treated under open surgery and amputation of traumatic limb was done for 13 patients. Amputation rate was higher in patients with cutoff and without runoff than those with cutoff and runoff (33.3% vs. 6.78%; p=0.002).Conclusion: Causes and types of traumatic arterial injury in our study were different with other reports. It was shown that angiographic findings were less important in prognosis and management of patients. Patients with spasm in angiographic findings had a better prognosis than other patients and mostly did not need any vascular surgery. The presence or absence of a distal run off in primary angiographic findings can have a predictive value in the final amputation rate.
Masoud Pezeshki Rad; Hassan Ravari; Aria Bahadori; Orkideh Ajami
Volume 2, Issue 1 , January 2014, , Pages 27-31
Abstract
Objective: To determine the etiology, signs and symptoms, angiography indications and angiography findings in patients with limb penetrating injuries suspected to have arterial injury.Methods: This was a cross-sectional study being performed in Imam Reza Hospital affiliated with Mashhad University of ...
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Objective: To determine the etiology, signs and symptoms, angiography indications and angiography findings in patients with limb penetrating injuries suspected to have arterial injury.Methods: This was a cross-sectional study being performed in Imam Reza Hospital affiliated with Mashhad University of Medical Sciences, Iran between September 2011 and March 2013. We included those patients with extremity blunt and penetrating injuries who were referred for angiography according to standard indications including abnormal distal pulses, complex fracture or dislocation, vascular proximity, fixed hematoma, distal nerve deficit, arterial bruit, thrill and massive soft tissue injuries.Results: During the study period, 148 patients (15 women and 133 men) with a mean age of 31±14.9 (11-82) years were evaluated. The most common cause of injury was motor vehicle accident (127 patients 85%). Angiography indications included abnormal distal pulse examination (124, 83.8%), complex fracture or dislocation (7, 4.7%), near arterial trauma (4, 2.7%), fixed hematoma (3, 2%), nerve damage (1, 0.7%). The angiography was found to be normal in 49 (33.1%) patients. In patients with abnormal angiography findings, 60 (60.6%) had cutoff with distal runoff, 21 (21.2%) had cutoff without runoff, 14 (14.1%) had arterial spasm. Other uncommon findings included active bleeding in 2 patients (2%), pseudoaneurysm in 1 (0.7%) and arteriovenous fistula in 1 (0.7%). Out of 4 patients (2.7%) with vascular proximity, only 1 (0.7%) had abnormal angiography.Conclusion: The most important factor in prediction of result of angiography was distal arterial pulses examination. But these data confirm the low incidence of vascular injury in asymptomatic patients with proximity. So the use of angiography when proximity is the sole indication in an asymptomatic patient with a normal vascular examination should be questioned.
