Willen Guillermo Calderon-Miranda; Hernando Raphael Alvis-Miranda; Andres M. Rubiano; Luis Rafael Moscote-Salazar
Volume 2, Issue 2 , April 2014, , Pages 96-98
Abstract
Traumatic brain injury is a common entity. However cerebral infarction in infants is a rare entity while the diagnosis of this pathology in the pediatric population is usually difficult. The mild head trauma is rarely accompanied by intracranial injury and even less, with cerebral infarction. We herein ...
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Traumatic brain injury is a common entity. However cerebral infarction in infants is a rare entity while the diagnosis of this pathology in the pediatric population is usually difficult. The mild head trauma is rarely accompanied by intracranial injury and even less, with cerebral infarction. We herein report the first case of cerebral infarction after a mild brain trauma in a 2-year-old Latin-American male patient, in which brain computed tomography (CT) scan was performed on the first day of the accident, showed right hemispheric cerebral ischemia compromising the fronto-parieto-occipital region. Conservative management was established. The patient died at day 5. So Brain CT scan may be beneficial to reveal any hemispheric infarction due to a probable mass effect.
Mehdi Ayaz
Volume 9, Issue 2 , April 2021, , Pages 96-100
Abstract
Introduction: Wound debridement is necessary before skin grafting or wound closure. Inappropriate wound bed preparation will led to graft rejection and sometimes catastrophic results, especially in large wounds,. Usage of popular debridement and excision devices such as dermatomes has some ...
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Introduction: Wound debridement is necessary before skin grafting or wound closure. Inappropriate wound bed preparation will led to graft rejection and sometimes catastrophic results, especially in large wounds,. Usage of popular debridement and excision devices such as dermatomes has some difficulties and disadvantages. In this study we will introduce metallic scrub sponge as a safe and effective debridement device.Methods: The surgeon usually uses a sterile metallic scrub sponge over the wound with transverse or rotational repeated movement. Wound preparing with metallic sponge should be stopped when pinpoint bleeding occurs. We used sterile metallic sponge for more than 2500 burn patients.Results: The results are excellent for deep second degree burn (and deeper burns at least 5-10 days after burn when some eschar loosening occurs). Work with scrub sponge was effective, fast and safe.Discussion: Metallic scrub sponge is a useful device for wound preparation due to its some special characteristics. Debridement of the burn wound with metallic sponge can preserve the spontaneous epithelialization potential of skin in second degree burns and reduce additional injury to the viable tissue that is inevitable by surgical debridement. Cost effectiveness, easy accessibility, safety, softness, inertness and some others are among the other advantages of metallic sponge usage for wound preparation.Conclusion: Due to metallic sponge’s simplicity and capability to remove necrotic loose tissues and easy accessibility everywhere and minimal adverse effects, it is a good first line tool for wound preparation and debridement.
Mahdi Moshki; Abdoljavad Khajavi; Homayoun Sadeghi-Bazargani; Shahram Vahedi; Saeid Pour-Doulati
Volume 8, Issue 2 , April 2020, , Pages 98-106
Abstract
Objective: To develop a self-completion pedestrians’ red-light violation behavior questionnaire (PRVBQ) based on the theory of planned behavior (TPB) and assess the content validity and reliability. Methods: This study was conducted in three phases of (i) PRVBQ development study; (ii) Content validity ...
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Objective: To develop a self-completion pedestrians’ red-light violation behavior questionnaire (PRVBQ) based on the theory of planned behavior (TPB) and assess the content validity and reliability. Methods: This study was conducted in three phases of (i) PRVBQ development study; (ii) Content validity study including face validity; and (iii) Reliability assessment. The directed content analysis method was used for the analysis of the qualitative interviews. The item impact score was used for face validity. Content validity index (CVI) in the item level and average scale level, and content validity ratio (CVR) were determined. Intra-class Correlation Coefficient (ICC), and Cronbach’s alpha was assessed for test-retest reliability and internal consistency respectively. Results: Draft questionnaire including 86 items was constructed. Sixteen items were eliminated due to low face and content validity, remaining 70 items in total. The PRVBQ was rated as having good content validity (individual items CVI ranged from .80 to 1, and overall PRVBQ CVI-Average=0.95, p=0.05). The direct measures (reflective indicators) showed excellent internal consistency with Cronbach’s alpha=0.9. All items showed excellent agreement. Conclusion: This study using a comprehensive process of development and assessment of content validity and reliability developed a content valid and reliable questionnaire predicting pedestrians’ red light violation behavior.
Reza Mohammadian; Afsoon Akbari; Mohmmadjavad Rajabi; Saman Nikeghbalian; Mahmood Shariat; Ahmad Monabati; Seyed Hamidreza Hosseinialhashemi
Volume 11, Issue 2 , April 2023, , Pages 102-105
Abstract
Wunderlich syndrome, also known as the spontaneous non-traumatic retroperitoneal hemorrhage, is anuncommon condition characterized by acute, spontaneous, non-traumatic renal hemorrhage into the subcapsularor perirenal spaces. The majority of the cases are caused by renal cell carcinoma or renal angiomyolipoma.Other ...
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Wunderlich syndrome, also known as the spontaneous non-traumatic retroperitoneal hemorrhage, is anuncommon condition characterized by acute, spontaneous, non-traumatic renal hemorrhage into the subcapsularor perirenal spaces. The majority of the cases are caused by renal cell carcinoma or renal angiomyolipoma.Other causes are arteriovenous malformation, cystic renal disease, and anticoagulation medications. Theclassic presentation is “Lenk’s triad” of acute flank pain, palpable flank mass, and hypovolemia. The diagnosisis based on clinical suspicion and confirmed by a CT scan, which is the preferred imaging modality. Due tothe rarity of these cases and the wide range of clinical manifestations, the treatment is divergent ranging fromconservative management to nephrectomy. Herein, we present a case of massive right renal hemorrhage causedby warfarin toxicity that was initially misdiagnosed as acute renal colic due to the patient’s refusal to refer tothe clinic during Corona Virus Disease- 19 era and was later managed with a right nephrectomy.
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.
Davood Farsi; Parviz Karimi; Mani Mofidi; Babak Mahshidfar; Mahdi Rezaei; Peyman Hafezimoghadam; Saeed Abbasi
Volume 5, Issue 2 , April 2017, , Pages 110-115
Abstract
Objective: To determine the effects of pre-injury consumption of anti-platelet agents on the 30-day outcomes of patients with mild traumatic brain injury (TBI).Methods: This prospective cohort study was conducted at three general hospitals in Tehran, Iran between July 2013 and July 2014. The study population ...
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Objective: To determine the effects of pre-injury consumption of anti-platelet agents on the 30-day outcomes of patients with mild traumatic brain injury (TBI).Methods: This prospective cohort study was conducted at three general hospitals in Tehran, Iran between July 2013 and July 2014. The study population included all patients with mild TBI aged over 18 years that medicated with aspirin or clopidogrel before occurring trauma. Within hospitalization, all patients were assessed with respect to in-hospital conditions especially complications and adverse events. After discharge, the individuals were followed for 30 days by telephone to assess mortality and disability using the Glasgow outcome scale (GOS).Results: Of 1140 patients with mild TBI, only 135 had previously received aspirin and/or clopidogrel. The mean age was dramatically higher in those who were taking aspirin or clopidogrel (p<0.001). The patients with previously use of anti-platelets were more transferred by ambulance when compared to another group (p=0.006). The patients on anti-platelets had significantly lower GCS on admission when compared to others (p<0.001). Length of hospitalization was significantly longer in those receiving anti-platelets (p=0.003). In follow-up, 30-day mortality and disability was revealed in 2.8% of patients that received only aspirin and 7.5% in aspirin with clopidogrel and in 1.6 % of those who did not receive drugs without any significant difference between aspirin and control group (p=0.208) and significant difference in aspirin with clopidogrel group (p<0.001). Conclusion: The premedication by anti-platelets (aspirin and/or clopidogrel) in patients with mild TBI leads to prolonged hospital stay, and increase rate of disability. Age and on admission GCS are the independent risk factors for predicting the outcome in patients with mild TBI receiving anti-platelet agents.
Hossein Hodjati; Parviz Mardani; Masoud Mousavi; Ahmad Hoseinzadeh; Sajjad Ahmadi; Sahar Sohrabi; Alireza Golchini
Volume 3, Issue 3 , July 2015, , Pages 111-113
Abstract
Traumatic injuries to great vessels are relative common in trauma practice. Blunt thoracic trauma may result in dissection injury to aorta and innominate artery. We herein present a late presentation of traumatic innominate artery aneurysm. A29-year-old woman presented with dyspnea to our emergency department. ...
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Traumatic injuries to great vessels are relative common in trauma practice. Blunt thoracic trauma may result in dissection injury to aorta and innominate artery. We herein present a late presentation of traumatic innominate artery aneurysm. A29-year-old woman presented with dyspnea to our emergency department. She had previous motor-vehicle accident a month before presentation for which had undergone chest tube insertion. She was diagnosed to have traumatic aneurysm of innominate artery resulting in tracheal stenosis resulting in acute life threatening respiratory failure. She underwent simultaneous aneurysm resection and tracheal reconstruction. She was uneventfully discharged from hospital. Any post-traumatic respiratory and cardiovascular symptoms may propound an undiagnosed serious injury to the great vessels. Extra and repetitive imaging studies may help us in better evaluation of traumatized patients with high energy mechanisms and sharp injuries to chest and neck.
Sumanta Kumar Ghosh
Volume 1, Issue 3 , July 2013, , Pages 127-129
Abstract
Major pancreatic injury following blunt abdominal trauma by itself is a relatively rare occurrence, and in vast majority of cases (95%) it is associated with injury to adjacent major vessels and organs; thus making isolated major pancreatic injury even rarer. While most pancreatic injuries are managed ...
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Major pancreatic injury following blunt abdominal trauma by itself is a relatively rare occurrence, and in vast majority of cases (95%) it is associated with injury to adjacent major vessels and organs; thus making isolated major pancreatic injury even rarer. While most pancreatic injuries are managed by simple measures like debridement and drainage, complex proximal injury poses surgical challenge regarding surgical skill and judgement. Disproportionate approach at any stage of management can contribute to high mortality and morbidity. Emergency pancreatoduodenectomy plays a limited but important role in managing serious trauma to proximal pancreas and duodenum. Author presents a case where isolated injury to head of pancreas required emergency pancreatoduodenectomy. After a bizarre road accident, a middle aged male underwent emergency laparotomy for intraperitoneal bleeding and during exploration a deep transverse laceration with ampullary disruption was found in the head of the organ. Duodenum in all its part was intact and there was no other injury. The nature and site of injury made emergency pancreatoduodenectomy the only viable option. Leaking pancreatojejunostomy enhances infective complications that lead to late mortality. To circumvent this problem there is enthusiasm for staged surgery with resection and tube pancreatostomy in first stage, leaving the difficult anastomosis for a later date, However, if the patient is haemodynamically stable and operated reasonably early, one stage pancreatoduodenectomy gives good result and avoids repeating surgery with inherent problems and reduces hospital stay. For successful management of pancreatic trauma it is essential to make early diagnosis of duct disruption, with sound application of operative skill and judgement by treating surgeon.
Sadettin Er; Bülent Çomçalı; Ahmet Soykurt; Bülent Cavit Yüksel; Mesut Tez
Volume 6, Issue 2 , April 2018, , Pages 128-132
Abstract
Objective: To investigate the clinical, imaging and laboratory findings for diagnosis of acute appendicitis (AA) in patients with a normal white blood cell count (WBCC).Methods: This retrospective cross-sectional study was conducted in Ankara Numune Training and Research Hospital, Ankara, Turkey, during ...
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Objective: To investigate the clinical, imaging and laboratory findings for diagnosis of acute appendicitis (AA) in patients with a normal white blood cell count (WBCC).Methods: This retrospective cross-sectional study was conducted in Ankara Numune Training and Research Hospital, Ankara, Turkey, during a 1-year period. To determine diagnostic factors in AA in patients with normal WBCC, medical records of eligible patients were reviewed for demographic and clinical variables, as well as patient outcome.Results: A total of 105 patients that had undergone appendectomy and were found to have a normal WBCC were included in the study. Of these patients, 53 (50.5%) were men and 52 (49.5%) were women. The mean age of the patients was 34.2±12.3 (min 14, max 78). The negative exploration rate was identified as 19%. In the multivariate analysis, only the diameter of appendix was statistically significant (p=0.002). ROC analysis revealed the cut off appendiceal diameter as 8 mm. Conclusion: In patients suspected of AA due to ≥8 mm appendiceal diameter determined by imaging, we recommend surgical treatment even if WBCC and neutrophil count are normal.
Willem Guillermo Calderon-Miranda; Hernando Raphael Alvis-Miranda; Gabriel Alcala-Cerra; Andres M Rubiano; Luis Rafael Moscote-Salazar
Volume 2, Issue 3 , July 2014, , Pages 130-132
Abstract
Traumatic basal ganglia hematoma is a rare condition defined as presence of hemorrhagic lesions in basal ganglia or adjacent structures suchas internal capsule, putamen and thalamus. Bilateral basal ganglia hematoma are among the devastating and rare condition. We herein report a 28-year old man, a ...
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Traumatic basal ganglia hematoma is a rare condition defined as presence of hemorrhagic lesions in basal ganglia or adjacent structures suchas internal capsule, putamen and thalamus. Bilateral basal ganglia hematoma are among the devastating and rare condition. We herein report a 28-year old man, a victim of car-car accidentwho was brought to our surgical emergency room by immediate loss of consciousness and was diagnosed to have hyperdense lesion in the basal ganglia bilaterally, with the presence of right parietal epidural hematoma. Craniotomy and epidural hematoma drainage were considered, associated to conservative management of gangliobasal traumatic contusions. On day 7 the patient had sudden neurologic deterioration, cardiac arrest unresponsive to resuscitation. Management of these lesions is similar to any other injury in moderate to severe traumatic injury. The use of intracranial pressure monitoring must be guaranteed.
Behnam Hosseini; Faramarz Mosaffa; Shideh Dabir; Hamed Tanghatari; Mehrdad Taheri
Volume 7, Issue 2 , April 2019, , Pages 130-136
Abstract
Objective: To evaluate the evolution pattern of epidural block after rotating the needle tip 45° to the operative side and evaluate its effects on patients’ hemodynamics and recovery profile in those undergoing arthroscopic knee surgery.Methods: Forty participants were randomly subdivided into ...
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Objective: To evaluate the evolution pattern of epidural block after rotating the needle tip 45° to the operative side and evaluate its effects on patients’ hemodynamics and recovery profile in those undergoing arthroscopic knee surgery.Methods: Forty participants were randomly subdivided into control and rotation group (n=20). An 18-gauge, 3.5 inch, Tuohy needle was placed at the level of L4-5 and pushed forward into the epidural space through parasagittal approach, in control group, the needle was pushed forward to the epidural space in cephaldad 90 degrees. For the rotation group, the needle was pushed forward to the epidural space and the tip was rotated 45 degrees to the surgical side.15 mL of bupivacaine 0.5% was injected and evolution of sensory and motor blocks until 2-segment regression of the sensory level below to T10 as well as total duration of motor block and surgery were recorded. Hemodynamic parameters (HR, MAP, and SPO2), hypotension, fluid intake, vasopressors, first ambulation and spontaneous urination were recorded. Statistical analysis was performed using SPSS and P≤0.5 considered significant.Results: Sensory block up to T10 level, Complete motor block and time for 2-segment regression of sensory level were earlier in the 45°-rotation than in the control group (p<0.001).Total duration of motor block in control group was lower than rotation group (p<0.001).Hypotension, N&V, vasopressors and fluid intake showed no statistically difference between the two groups (p=0.219). First spontaneous urination and ambulation were significantly lower in rotation group (p<0.001).Conclusion: 45 degrees’ needle rotation to the surgical side provides a faster block evolution and hastened recovery profile with no significant difference in hemodynamic fluctuations.Clinical trial registry: IRCT20130518013364N7
Shailesh Kumar; Priyadarshi Dikshit; Shubhendu Bhaduri; Swati Sattavan
Volume 3, Issue 4 , October 2015, , Pages 144-147
Abstract
Intra-abdominal Hernias are rare conditions usually secondary to congenital defects, with pericecal hernias accounting for a minority of them. They can be difficult to diagnose due to non-specific presentations but may lead to strangulation and thus require early management. We herein report a rare case ...
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Intra-abdominal Hernias are rare conditions usually secondary to congenital defects, with pericecal hernias accounting for a minority of them. They can be difficult to diagnose due to non-specific presentations but may lead to strangulation and thus require early management. We herein report a rare case of pericecal hernia with gangrenous appendicitis in an 88 year-old lady presenting with features of acute intestinal obstruction and right iliac fossa lump, which on exploration was found to be a pericecal hernia with knotting, strangulation, and gangrenous changes of appendix. This case highlights the need of a high index of suspicion for internal hernias and that of prompt operative intervention to avoid enterectomies and to improve outcome.
Isidro Martínez Casas; María Auxiliadora Amador Marchante; Mihai Paduraru; Ana Isabel Fabregues Olea; Andreu Nolasco Bonmatí; Juan Carlos Medina
Volume 4, Issue 3 , July 2016, , Pages 150-155
Abstract
Objective: To determine the predictive and diagnostic value of thorax trauma severity score (TTSS) in a population of thoracic trauma patients admitted to a secondary level trauma center.Methods: A Retrospective analysis of patients admitted over a period of two years with IDC-9 codes related to thoracic ...
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Objective: To determine the predictive and diagnostic value of thorax trauma severity score (TTSS) in a population of thoracic trauma patients admitted to a secondary level trauma center.Methods: A Retrospective analysis of patients admitted over a period of two years with IDC-9 codes related to thoracic trauma was undertaken. The association of TTSS with complications and mortality was evaluated. We also determined the predictive value of TTSS using receiver operating characteristic curve (ROC).Results: 238 patients with thoracic trauma, mostly middle-aged (62.2 ± 15 years), were included. The main mechanisms of injury were falls and traffic accidents. Thirty-three patients had important extra-thoracic injuries, but only 9 presented an ISS> 15. The average ISS was 3 ± 5; Morbidity was 2.5% and mortality was 2.1% as a result of thoracic injury and these patients had significantly higherTTSS values. Each score component was analyzed separately, showing significant association with complications and mortality. The area under the curve for TTSS was significant for predicting complications (0.848) and mortality (0.856) values. TTSS with a cut off value of 8 points had a sensitivity of 66% and specificity of 94% to predict complications and 80% sensitivity and 94% specificity for predicting mortality.Conclusions: The TTSS is an appropriate and feasible tool to predict the development of complications or mortality in a population of mostly mild thoracic trauma.
Ee Lyn Chan; Jawaad Saleem Malik; Carlos Gomez
Volume 9, Issue 3 , July 2021, , Pages 151-154
Abstract
Blunt chest trauma is a rare cause of acute coronary syndrome and can be masked by other injuries in polytrauma patients. It can have devastating consequences due to damage to the myocardial tissue if left unrecognized. Myocardial injury can result in life-threatening arrhythmias and complications ...
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Blunt chest trauma is a rare cause of acute coronary syndrome and can be masked by other injuries in polytrauma patients. It can have devastating consequences due to damage to the myocardial tissue if left unrecognized. Myocardial injury can result in life-threatening arrhythmias and complications such as systolic and diastolic dysfunction. This can significantly affect patients’ quality of life. A 34-year-old man involved in a paragliding incident in Kazakhstan. His equipment failed at 30 meters height and result him to be propelled at high velocity to the ground. He sustained multiple injuries including spinal fractures, lung contusions and a mediastinal haematoma. He was transported to a local hospital and noted to have ST segment elevation on his admission electrocardiogram (ECG). He underwent an angiogram that showed sub-occlusion of his left anterior descending (LAD) artery. This resulted in a time-critical Percutaneous Coronary Intervention (PCI). He was stabilized and repatriated to the UK to manage of remaining injuries.
Parisa Javidi Parsijani; Nima Pourhabibi Zarandi; Shahram Paydar; Hamidreza Abbasi; Shahram Bolandparvaz
Volume 1, Issue 4 , October 2013, , Pages 158-163
Abstract
Objectives: To evaluate the accuracy of sonography in diagnosing acute appendicitis in patients with Alvarado score 4–7.Methods: This is a retrospective cross-sectional study being performed in Namazee hospital affiliated with Shiraz University of Medical sciences during a one year period from 9/2007 ...
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Objectives: To evaluate the accuracy of sonography in diagnosing acute appendicitis in patients with Alvarado score 4–7.Methods: This is a retrospective cross-sectional study being performed in Namazee hospital affiliated with Shiraz University of Medical sciences during a one year period from 9/2007 to 9/2008. We evaluated all patients with Alvarado score 4-7 and divided them in two groups: those with Ultrasound study prior to surgery and those without any imaging modalities for diagnosis of AA. The demographic information, histopathology, physical examination, laboratory data, sonography report and histopathological reports of patients were gathered. Results: A total of 238 patients had Alvarado scores 4-7 including 160 males and 78 females. 110 patients did not have any imaging and 128 had undergone sonography before operation. Ultrasound had overall sensitivity of 75 %, specificity 69.2 %, PPV 88 %, NPV 46.1% and accuracy of 73.6 %. Negative appendectomy rate was20.9 % and 23.4 % in those without sonography and inpatients with sonography respectively, with a higher rate in females.Conclusion: Ultrasound is more useful when the patient is female and the result of sonography is positive; however, it is not reliable when the result is negative and maybe other diagnostic modalities such as CT scan can help us in better diagnosis of Acute Appendicitis.
Mousa Taghipour; Nima Derakhshan; Fariborz Ghaffarpasand
Volume 2, Issue 4 , October 2014, , Pages 166-169
Abstract
Syringobulbiais very rare condition defined as slit-like fluid cavity in the brain stem. Several conditions have been reported to be associated with syringobulbia including neoplasms, spinal cord traumas or lesions such as tethered cord, hind-brain herniation, infections such as meningitis and in isolation.Although ...
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Syringobulbiais very rare condition defined as slit-like fluid cavity in the brain stem. Several conditions have been reported to be associated with syringobulbia including neoplasms, spinal cord traumas or lesions such as tethered cord, hind-brain herniation, infections such as meningitis and in isolation.Although post-traumatic syringomyelia has been wieldy described previously, traumatic brain injury has not been reported as the mechanism and etiology of isolated syringobulbia. We herein report a 24-year old man with previous history of severe traumatic brain injury who presented with recent onset inability to walk or coordinate movements, ataxia, dysphonia, dysarthria, bilateral third nerve palsy with fixed dilated pupils and eyes deviated outward and downward.He was further diagnosed to have isolated syringobulbia extending to upper pons and lower midbrain.Isolated post-traumatic syringobulbia is extremely rare condition presenting insidiously with cranial nerve palsies, ataxia and dysarthria.
Mohammad Ali Ashja Zadeh; Mohsen Ebrahimi; Amir Ahmad Salarian; Seyyed Reza Abtahi; Alireza Jahandideh
Volume 8, Issue 3 , July 2020, , Pages 169-178
Abstract
Objective: To evaluate the wound healing activity of Crocus pallasii subsp. haussknechtii boiss leaves extract on infected wounds in diabetic rats. Methods: Fifty male diabetic rats were randomized into two sets of 25 animals each. Each group was sub divided into five groups of five animals, each for ...
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Objective: To evaluate the wound healing activity of Crocus pallasii subsp. haussknechtii boiss leaves extract on infected wounds in diabetic rats. Methods: Fifty male diabetic rats were randomized into two sets of 25 animals each. Each group was sub divided into five groups of five animals, each for excisional and incisional wound models, respectively. Induction of diabetes was achieved using 60 mg/kg streptozotocin. In group I, 0.1 mL sterile saline 0.9% solution was added to the wounds with no infection. In group II, the wounds were infected with Methicillin-resistant staphylococcus aureus (MRSA) and only treated with 0.1 mL the sterile saline 0.9% solution. In group III, infected wounds were treated with application of base formulation ointment. In group IV, animals with infected wounds were treated with 0.1 mL topical application of 1 mg/mL methicillin and base formulation ointment. In group V, animals with infected wounds were treated with topical application of 0.1 mL solution of methicillin (1 mg/mL) and with 1g of powder extract of the plant material in ointment. The healing of the wound was assessed based on planimetry, hydroxyproline estimation, microbiological, biomechanical and biochemical studies Results: Microbiological examination, planimetric, histological and quantitative morphometric studies and determination of hydroxyproline levels showed that there was significant difference between animals in group V compared to other groups (p=0.001). Biomechanical indices in incisional groups showed there was significant difference between animals in group V compared to other groups (p=0.001). Conclusion: It was possible to conclude that the ointment of the extract of Crocus pallasii subsp. haussknechtii boiss. leaves have significant wound-healing activity in diabetes.
Mehdi Ayaz; Abdolkhalegh Keshavarzi; Hamid Bahadoran; Peyman Arasteh; Sam Moslemi
Volume 5, Issue 3 , July 2017, , Pages 179-183
Abstract
Objectives: To compare the outcomes of early excision and grafting between pediatric and adult patients with deep burns of less than 40% total body surface area burns (TBSA).Methods: This is a prospective comparative study. Overall, 106 patients admitted to Ghotbodin Burn Center in Shiraz, Iran ...
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Objectives: To compare the outcomes of early excision and grafting between pediatric and adult patients with deep burns of less than 40% total body surface area burns (TBSA).Methods: This is a prospective comparative study. Overall, 106 patients admitted to Ghotbodin Burn Center in Shiraz, Iran from September 2012 to September 2013, were included in the study. All patients had less than 40% TBSA burn and had excision and grafting under 14 days from their injury. Patients were divided into two age groups of younger than 14 (n=49) and older than 14 (14-65) years old (n=57). During a 6-month follow-up period, the two groups were compared regarding mean percentage of graft take, total scar score, duration of hospital stay and itching score.Results: During follow-up, the two groups did not show a significant difference in graft take, total scar score and itching score (p=0.461, p=0.363 and p=0.637, respectively). Clinically, the pediatric group showed less hospital stay (12.25±9.1 vs. 16±12.9), however this was not statistically significant (p=0.091). Conclusion: Adults and elderly patients (14–65 years old) compared to pediatric patients (less than 14 years old) with less than 40% TBSA burns, can expect similar results regarding scar score, graft take, itch score and hospital stay, after excision and grafting performed less than two weeks from their initial injury.
Amir Hossein Shams; Mohammad Hadi Niakan; Mahsa Ahadi; Majid Rasekhi Nejad; Samane Sardar Kermani
Volume 10, Issue 4 , October 2022, , Pages 196-200
Abstract
Peritoneal tuberculosis (PTB) is a rare subset of extrapulmonary tuberculosis which account for only 0.5-1% of all cases. PTB diagnosis can be challenging due to nonspecific clinical manifestations. We present a known case of pulmonary tuberculosis that admitted to the surgery ward due to the ...
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Peritoneal tuberculosis (PTB) is a rare subset of extrapulmonary tuberculosis which account for only 0.5-1% of all cases. PTB diagnosis can be challenging due to nonspecific clinical manifestations. We present a known case of pulmonary tuberculosis that admitted to the surgery ward due to the major complaint of abdominal pain since ten days before admission. In imaging studies, positive findings favoring mechanical obstruction were detected. There were also several hypodense lesions in the liver suggestive of visceral tuberculosis. An adhesion was noted during exploratory laparotomy prior to the ileocecal valve responsible for intestinal obstruction, which was released. Pathology reports of excised tissues were consonant with the PTB diagnosis. PTB diagnosis can be challenging because of its presentation. This can delay the treatment of patients and thus increase morbidity and mortality. As a result, physicians should always be aware of the PTB diagnosis in patients with nonspecific abdominal involvement.
Majid Reza Farrokhi; Seyed Reza Mousavi; Mohammad Reza Tamjidi; Saeed Tayebi Khorami; Abbas Khosravi farsani; Jaloliddin Mavlonov; Hamid Jangi Aghdam; Armin Akbarzadeh
Volume 11, Issue 4 , October 2023, , Pages 196-199
Abstract
Thoracic ossification of the posterior longitudinal ligament (OPLL) is a rare condition that is mainlyaccompanied by cervical OPLL or ossification of thoracic ligamentum flavum. In case of causing neurologicalmanifestations, it is preferred to treat the condition surgically. Several surgical procedures ...
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Thoracic ossification of the posterior longitudinal ligament (OPLL) is a rare condition that is mainlyaccompanied by cervical OPLL or ossification of thoracic ligamentum flavum. In case of causing neurologicalmanifestations, it is preferred to treat the condition surgically. Several surgical procedures were introduced,including anterior, posterior, or combined approaches. Laminectomy with instrumented fusion is the mostpopular procedure utilized via the posterior approach. A 32-year-old obese woman, who suffered from backpain and weakness in both lower extremities for one month, was referred to our spine outpatient clinic. Imagingrevealed lower thoracic OPLL (T7/T8 & T8/T9 & T9/T10). The posterior longitudinal ligament had a mixedossification pattern (beaked and continuing cylindrical). To maintain thoracic spine stability and prevent futurekyphosis, we performed laminectomy and long segment fixation (T7 to T12). The post-operative neurologicalexamination revealed a considerable increase in muscle strength and significant pain relief.
Saber Ghaffari-fam; Ehsan Sarbazi; Amin Daemi; Mohammad Reza Sarbazi; Hossein Ali Nikbakht; Shaker Salarilak
Volume 4, Issue 4 , October 2016, , Pages 223-229
Abstract
Objectives: To determine the epidemiology of injuries of the motorcyclists in road traffic accidents (RTIs) between 2008 and 2014 in East Azarbayejan province of Iran.Methods: A cross-sectional study was performed in East Azerbaijan province in Imam Reza hospital on motorcyclists subjected to injuries ...
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Objectives: To determine the epidemiology of injuries of the motorcyclists in road traffic accidents (RTIs) between 2008 and 2014 in East Azarbayejan province of Iran.Methods: A cross-sectional study was performed in East Azerbaijan province in Imam Reza hospital on motorcyclists subjected to injuries in RTIs between 2008 and 2014. Demographic characteristics (age, sex), duration of hospitalization, final status of injured people after discharge from the hospital, admission ward, number of admissions due to injuries in RTIs, nature of injury, and the clinical services provided to injured people were gathered from hospital information system (HIS). Demographic characteristics (age, sex), duration of hospitalization, final status of injured people after discharge from the hospital, admission ward, number of admissions due to injuries in RTIs, injured site of the body, nature of injury, and the clinical services provided injured people were gathered from HIS. Standardized data collection form was used for uniform handling of the data.Results: Most of the victims (94.4%) were male. The most frequent injuries pertained to the age group of 18-30 with 1676 (51.4%) injuries. Head, abdomen, lower back, lumbar spine, and pelvis, were the most common injured sites, respectively. Reduction of fracture and dislocation and cranial puncture were the most common provided services. The lowest survival time belonged to the age group over 60 years old.Conclusion: Injuries to the head are the most prevalent injuries among motorcyclists in RTIs. So it is suggested that proper interventions be implemented to ensure wearing helmet by motorcyclist and pillion passengers.
Mehdi Safarpour; Seyed Reza Hosseini; Masume Mohamadzade; Ali Bijani; Akbar Fotouhi
Volume 6, Issue 3 , July 2018, , Pages 226-232
Abstract
Objective: To determine the incidence and predictive factors of the falls in elderly women in Northern Iran.Methods: A total of 717 elderly women aged 60 years and above in Amirkola, Northern of Iran participated in this study. Age, history of falls during the 12 months leading to the study, accompanying ...
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Objective: To determine the incidence and predictive factors of the falls in elderly women in Northern Iran.Methods: A total of 717 elderly women aged 60 years and above in Amirkola, Northern of Iran participated in this study. Age, history of falls during the 12 months leading to the study, accompanying diseases, status of balance, cognitive status, orthostatic hypotension, state of depressive symptoms, strength of quadriceps muscles and serum vitamin D level were assessed as independent variables during baseline measurement. Incidence of fall (dependent variable) was recorded during a six-month follow-up period.Results: Of the participants, 7.8% had experience of fall, out of which 50.0% experienced it once, 25.0% twice, and the rest three times or more. With aging, the incidence of orthostatic hypotension also increased and symptomatic depression became aggravated. In the final model, the variables of the number of accompanying diseases (RR=1.78, 95% CI: 1.00-3.18), severe cognitive impairment (RR=12.70, 95% CI: 3.05-52.86), and depressive symptoms (RR=3.19, 95% CI: 1.48-6.86) remained as strong associated variables for incidence of fall.Conclusion: With increasing severity of depressive symptoms and cognitive impairment along with the comorbidities, incidence of fall also increases in the elderly. Thus, psychological aspects of the elderly and comorbidities in this group should be taken care of seriously.
Nabil Muhammad Al Kuddoos; Ahmad Khaldun Ismail; Kevin Wong Chuing Shen; Nur Amirah Shibraumalisi; Asmil Yuzairi Yunus
Volume 8, Issue 4 , October 2020, , Pages 249-252
Abstract
Pancreatic injury in paediatrics is a rare condition and can be difficult to diagnose. The diagnostic challenge is due to its symptom of vague abdominal pain which usually results in late presentation. Elevated biochemical markers such as amylase and lipase can aid in the evaluation of pancreatic injury, ...
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Pancreatic injury in paediatrics is a rare condition and can be difficult to diagnose. The diagnostic challenge is due to its symptom of vague abdominal pain which usually results in late presentation. Elevated biochemical markers such as amylase and lipase can aid in the evaluation of pancreatic injury, however, it is not specific and is only evident after several hours of trauma. Ultrasound is commonly used as a primary modality to evaluate abdominal organ injuries, but its role in detecting pancreatic injury is limited due to low sensitivity. High index of suspicion is needed to avoid undiagnosed pancreatic injury which could be lethal to children. We herein report a case of delayed presentation of isolated pancreatic tail injury in a child who was sufficiently diagnosed with ultrasound and treated conservatively. Proper initial assessment and diagnosis will allow appropriate management of pancreatic injury. Conservative management should include serial imaging to look at the evolution of pancreatic injury and detect complications such as pseudocyst or abscess formation.
Masoud Hashemi; Payman Dadkhah; Mehrdad Taheri; Seyed Mohammdareza Haji; Seyed Abootorabi; Bahram Naderi-nabi
Volume 7, Issue 3 , July 2019, , Pages 251-255
Abstract
Objective: To investigate the success rate (technical precision) of ultrasound-guided lumbar transforaminal epidural steroid injection, which was validated by conventional fluoroscopic technique.Methods: A total of 20 patients with unilateral single-level lumbar foraminal disc protrusion causing radiculopathy ...
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Objective: To investigate the success rate (technical precision) of ultrasound-guided lumbar transforaminal epidural steroid injection, which was validated by conventional fluoroscopic technique.Methods: A total of 20 patients with unilateral single-level lumbar foraminal disc protrusion causing radiculopathy were enrolled. Using transforming route, the needle location was determined by an axial (transvers) view of the ultrasound with fluoroscopic confirmation. We determined the needle placement accuracy of ultrasound- guided lumbar transforaminal injections approach. Results: The accuracy of ultrasound-guided interventions was 90% as confirmed by fluoroscopy. There were 2 failed cases at the L4-L5 level in the US-guided. The success rate in L5-S1 level was 100%, in L4-L5 level was 80% and in L3-L4 level was 100%. No complications were noted.Conclusion: Ultrasound-guided lumbar transforaminal epidural injections are accurate and feasible in clinical setting with an accuracy of 90% and no complications.
Haleh Ghaem; Maryam Soltani; Mahnaz Yadollahi; Tanaz Valad Beigi; Atousa Fakherpour
Volume 5, Issue 4 , October 2017, , Pages 273-279
Abstract
Objective: To epidemiologically assess the accidents and incidents in the injured pedestrians referred to Shahid Rajaee Hospital, Shiraz in order to provide basic preventive strategies and reduce injuries and fatalities caused by traffic accidents in pedestrians.Methods: This cross-sectional study was ...
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Objective: To epidemiologically assess the accidents and incidents in the injured pedestrians referred to Shahid Rajaee Hospital, Shiraz in order to provide basic preventive strategies and reduce injuries and fatalities caused by traffic accidents in pedestrians.Methods: This cross-sectional study was conducted on 5840 injured pedestrians referred to Shahid Rajaee Hospital, Shiraz from 2009 to 2014. The baseline characteristic including the demographic and clinical information, the mechanism of injury, injury severity score (ISS) and outcome determinants. We also recorded the outcome measures and the mortality. Multivariate logistic regression analysis was performed to investigate the factors related to mortality rate and Length of Stay (LOS) in hospital.Results: In our study, the history of 5840 injured pedestrians was analyzed. The mean age of the patients was 41.32±19.21 years. Multivariate logistic regression indicated that mortality increased with age. Moreover, the odds of mortality was more in patients with Injury Severity Score (ISS) between 16 and 24 [OR: 12.94, 95% CI (3.78-32.66), p=0.001] and injuries in the head and neck [OR: 7.92, 95% CI (4.18-14.99), p=0.020]. LOS in hospital was also higher in patients with ISS > 25 [OR: 16.65, 95%CI (10.68-25.96), p=0.001].Conclusion: Pedestrians have always been one of the most vulnerable road users. Our study indicated that the adverse consequences and mortalities in pedestrians increased with age. Hence, approaches are required to improve primary prevention programs and reduce deaths and injuries due to this major public health problem.
