Amene S. Sarvestani; Gholam Reza Pishdad; Shahram Bolandparvaz
Volume 1, Issue 4 , October 2013, , Pages 164-170
Abstract
Objectives: To determine the prevalence and predisposing factors of mucormycosis in patients with diabetes mellitus (DM) in a Shiraz referral centers.Methods: This retrospective case control study, reviewed the medical records of 162 patients with pathologically confirmed diagnosis of mucormycosis hospitalized ...
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Objectives: To determine the prevalence and predisposing factors of mucormycosis in patients with diabetes mellitus (DM) in a Shiraz referral centers.Methods: This retrospective case control study, reviewed the medical records of 162 patients with pathologically confirmed diagnosis of mucormycosis hospitalized in two major Shiraz University hospitals during the last 21 years. For each diabetic patient, two patients with diabetic ketoacidosis (DKA) matched for age, sex and the date of admission was selected as control group. Age, type of diabetes mellitus (DM) and duration of involvement as well as paraclinical findings were compared between cases and controls.Results: There were 162 patients with murormycosis of which 30 (18.5%) had DM as predisposing factor. Diabetes was the second common predisposing disease next to leukemia. There were 19 (63.3%) women and11 (36.7%) men among the patients. The overall mortality rate was 53.33% mortality rate. The mean age of the patients was 45.3 ± 17.6 years. The mean duration of diabetes in case and control groups were 5.75 ± 5.43 and 7.2 ± 7.85 years respectively, without any statistical significance between them (p=0.063). Blood sugar in patients was lower than control group (p=0.012). Serum bicarbonate level in case group was higher than in control group (p<0.001). Arterial pH in control group was more acidic than case group (p<0.001). Insulin dependent DM was significantly more prevalent in control group compared to case group (73.4% vs. 36.6%; p=0.002).Conclusion: Our study showed that the number of hospitalized patients with mucormycosis over the last 7 years has been decreased which is due to better control of infection in diabetics. In addition to hyperglycemia and acidosis, several other unknown factors like immune defects may predispose diabetics to this fungal infection.
Shahram Paydar; Pouya Farhadi; Fariborz Ghaffarpasand; Ali Taheri; Arash Farbood; Gholamreza Dabiri; Zahra Ghahramani; Shahram Bolandparvaz; Hamid Reza Abbasi
Volume 2, Issue 4 , October 2014, , Pages 170-171
Maryam Gholami; Sedigheh Torabi Davan; Maryam Gholami; Shahram Boland Parvaz; Mehrnaz Gholami; Parisa Chamanpara; Leila Shayan
Volume 8, Issue 3 , July 2020, , Pages 179-185
Abstract
Objective: To investigate the effects of sesame oil extracted from tahini (Ardeh) on pain severity in patients with upper or lower limbs trauma. Methods: This double-blinded randomized clinical trial study was conducted on 120 patients with upper or lower trauma in Shahid Rajaee Hospital, Shiraz, Iran, ...
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Objective: To investigate the effects of sesame oil extracted from tahini (Ardeh) on pain severity in patients with upper or lower limbs trauma. Methods: This double-blinded randomized clinical trial study was conducted on 120 patients with upper or lower trauma in Shahid Rajaee Hospital, Shiraz, Iran, from May the 1st through November 30th, 2016. The patients were randomly assigned to two groups using block randomization. The intervention group received topical sesame oil extracted from tahini (Ardeh) and the placebo group received cooking oil. Pain severity, pain sensitivity and heaviness of painful site were assessed. Results: Overall, we included 90 patients with traumatic limb injuries in this study who were randomized to two study groups. The mean age of the patients was 28.3 ± 6.8 (ranging from 25 to 35) years and there were 63 (70%) men and 27 (30%) women among the patients. In the sesame oil group, the mean changes in the pain severity (-1.53 ± 0.57, p <0.001), pain sensitivity (-1.45 ± 0.64, p <0.001) and heaviness of painful site (-1.56 ± 0.68, p <0.001) were significantly lower when compared to the placebo group in the second day of the intervention. None of the patients experience adverse drug effects. Conclusion: Our findings suggest that the topical use of sesame oil extracted from Tahini has a pain reliever effect on the skin after bruising and it helps prevent skin discoloration in patients with traumatic injuries of limbs. Clinical Trial Registry: IRCT20171017036838N1
Shahab Shahabi Shahmiri; Mohsen Kolahdouzan; Ara Omrani; Mehdi Khazaei; Hamid Salehi; Abbas Motevalian; Rastin Mohammadi Mofrad; Mohammad Taghi Rezaei; Helia Hemmasian
Volume 5, Issue 3 , July 2017, , Pages 184-189
Abstract
Objectives: To investigate the determinants of mortality and the lethal area 50 (LA50) in large series of Iranian burn patients admitted to a single burn center.Methods: This cross-sectional study was conducted in Shahid Motahari burn center of Tehran, Iran during a 1-year period from 2011 to 2012. We ...
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Objectives: To investigate the determinants of mortality and the lethal area 50 (LA50) in large series of Iranian burn patients admitted to a single burn center.Methods: This cross-sectional study was conducted in Shahid Motahari burn center of Tehran, Iran during a 1-year period from 2011 to 2012. We included all the burn patients who were admitted to our center during the study period. Those with incomplete medical records and those referred to other centers were excluded from the study. The medical records of the included patients were reviewed and the demographic, clinical, laboratory and outcome measures were recorded. The mortality rate was recorded and the determinants of LA50 were analyzed in a univariate and stepwise multivariate model.Result: Overall we included a total number of 1200 subjects with mean age of 30.8 ±18 years. There were 907 (75.6%) men and 293 (24.4%) women among the patients. The total LA50 was 55.5% (95% CI: 52.98%-58.3 %). There was a significant difference between age group >61 years and two 11-20 and 21-30 groups regarding LA50. The advanced age (p<0.001), female gender (p=0.002), inhalational injury (p<0.001) and burn extension determined by TBSA% (p<0.001) were significantly associated with mortality. In addition, male gender (p=0.087), flame (p=0.156), scald (p=0.088) and chemical injuries (p=0.071) were not associated with mortality.Conclusion: The LA50 determine din our study is still much lower than that reported in developed countries, as a result, the quality of medical care is lower. Female gender, age, inhalational injury and extension of burn determined by TBSA% were found to be the independent risk factors of mortality in burn patients in our series.
Mojtaba Heydari; Behnam Dalfardi; Mahdie Hajimonfarednejad; Mohammad Hashem Hashempur
Volume 11, Issue 4 , October 2023, , Pages 200-201
Abstract
This paper offers a historical exploration of how death was diagnosed in Persian medicine, highlighting the evolution of diagnostic criteria and the contributions of key scholars. In the post-medieval era, defining death and establishing diagnostic criteria underwent significant development, albeit with ...
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This paper offers a historical exploration of how death was diagnosed in Persian medicine, highlighting the evolution of diagnostic criteria and the contributions of key scholars. In the post-medieval era, defining death and establishing diagnostic criteria underwent significant development, albeit with ongoing debates. Notably, medieval Persian scholars, such as Qutb al-Din al-Shirazi, played a crucial role in this discourse. Qutb al-Din al-Shirazi, a prominent Persian polymath, synthesized earlier knowledge to provide a comprehensive set of diagnostic criteria for death in traditional Persian medicine. These criteria encompassed physical examinations like assessing nail shininess, feeling pulsatile vessels in specific areas, observing pupillary reactions to light, and even monitoring the movement of a thread near the mouth and nose. His mention of the pupillary light reflex is one of the earliest known references to this phenomenon in medical history. Medieval Persian practices also involved placing a water container on the chest of the individual to detect the absence of chest wall motion associated with respiration as a sign of death. Furthermore, scholars like Ibn-e Sina (Avicenna) stressed the importance of monitoring pulse and respiration as vital signs, especially when administering potentially lethal drugs. In cases of uncertain diagnosis, such as stroke, medieval Persians postponed burials for up to three days. These historical insights provide a fascinating glimpse into the evolving understanding of death in Persian medicine and the intricate methods used for its diagnosis.
Hamed Ghoddusi Johari; Seyed Arman Moein
Volume 10, Issue 4 , October 2022, , Pages 201-204
Abstract
Blunt traumatic aortic injury is a deadly phenomenon in traumatic injuries. Damage control is essential in the management of traumatic patients. We reported a 20-years-old man brought to the trauma center from a car turnover crash scene. Blunt traumatic aortic injury grade III was revealed ...
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Blunt traumatic aortic injury is a deadly phenomenon in traumatic injuries. Damage control is essential in the management of traumatic patients. We reported a 20-years-old man brought to the trauma center from a car turnover crash scene. Blunt traumatic aortic injury grade III was revealed by contrast-enhanced computed tomography requiring urgent intervention. After an uneventful open repair of the aorta with Dacron graft, diffuse blood oozing occurred from the mediastinum and left pleural cavity. We packed the thoracic bleeding sites and removed the packings after four days. The patient developed no signs of cardiopulmonary compromise until the removal of the packings. Later, the patient was discharged with no complications. Through the followups, he had no complaint regarding the surgery. The patient has a normal chest x-ray one year later. Thoracic gauze packing is limitedly practiced due to concerns for cardiopulmonary compromises. To the best of our knowledge, this is the first time that this technique has been performed in the open repair of blunt traumaticthoracic aortic injury as damage control.
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.
Salman Khazaei; Shahab Rezaeian; Sakineh Mazharmanesh; Mahin Ahmadi-Pishkuhi; Vali Baigi; Zaher Khazaei; Yousef Veisani
Volume 6, Issue 3 , July 2018, , Pages 233-238
Abstract
Objective: To investigate the epidemiological aspects of all-cause injuries in Hamadan province during a 6-year period.Methods: We conducted a cross-sectional study on injured subjects admitted to private or governmental hospitals in Hamadan province during March 2009 to March 2015. The epidemiological ...
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Objective: To investigate the epidemiological aspects of all-cause injuries in Hamadan province during a 6-year period.Methods: We conducted a cross-sectional study on injured subjects admitted to private or governmental hospitals in Hamadan province during March 2009 to March 2015. The epidemiological characteristics were retrieved from a registry-based system including gender, residency, injury mechanism and date of injury occurrence, outcome of hospitalization (full recovery/disability/death).Results: Totally, 135,925 hospitalized injured cases were recorded. The majority of cases were male (72.6%) and were occurred in urban areas (60%), about 40% of patients were in 20-34 years’ age group, and the highest proportion (30.13%) of injuries occurred in summer. Logistic regression showed that the odds of disability vs. recovery was significantly higher in rural areas [Adjusted odds ratio (AOR) =3.42] and the odds of death vs. recovery was higher among male gender (AOR=1.46). In addition, comparing to the 0-4-year age-group, odds of death were significantly higher in middle aged and elderly victims. Conclusion: Our findings showed that middle age groups, male gender and urban area increase the odds of death. Injured males and old age subjects had the highest odds of death and out of residential area injuries were common cause of leading death injuries.
Kam Lun Ellis Hon; Szewei Huang; Wai Sang Poon; Hon Ming Cheung; Patrick Ip; Benny Zee
Volume 7, Issue 3 , July 2019, , Pages 256-262
Abstract
Objective: To determine the mortality, morbidity, types of intracranial hemorrhages, and factors associated with length of stay (LOS) associated with accidental traumatic brain injury (TBI) at a pediatric intensive care unit (PICU) of a regional trauma center in an Asian city.Methods: This study is a ...
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Objective: To determine the mortality, morbidity, types of intracranial hemorrhages, and factors associated with length of stay (LOS) associated with accidental traumatic brain injury (TBI) at a pediatric intensive care unit (PICU) of a regional trauma center in an Asian city.Methods: This study is a retrospective review of types of head injury, mortality and morbidity demographics of patients admitted to a PICU with TBI. All patients with accidental TBI were included, namely road traffic injury (RTI) and fall, and their demographics compared. Non-accidental injuries (NAI) were excluded.Results: 95 children (78% males) were admitted to a PICU with RTI or falls from 2002 to 2017. They accounted for 3.7% of PICU admissions. Comparing with falls, victims of RTI were older (p<0.001) and more likely to suffer from skull fracture (p=0.017). There were 4 deaths with falls (6.8%) but none with RTI. Subarachnoid hemorrhages, extradural hemorrhages, the use of mechanical ventilation, inotropes and neurological supports were associated with longer LOS in PICU in these injuries (p<0.001).Conclusion: A longer PICU LOS is associated with extradural and subarachnoid hemorrhages, usage of inotropes, mechanical ventilation and neurological supports in falls and RTI. Three-quarters of victims are males. Preventive health education should be especially directed to boys to reduce severe TBI in this Asian city.
Robab Mehdizadeh Esfanjani; Homayoun Sadeghi-Bazargani; Mina Goletsani; Reza Mohammadi
Volume 5, Issue 4 , October 2017, , Pages 280-284
Abstract
Objective: To investigate epidemiological aspects of injuries among Iranian children under 7 years of age using obtained data from a national registry.Methods: Injury data were derived from a national-based injury supervision system during 2000–2002. This registry involved all of home-related injuries ...
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Objective: To investigate epidemiological aspects of injuries among Iranian children under 7 years of age using obtained data from a national registry.Methods: Injury data were derived from a national-based injury supervision system during 2000–2002. This registry involved all of home-related injuries for children less than 7 years of age that treated in health or emergency centers. The study population included 25% of Iranian people. The descriptive statistical methods were used for representing the distribution of the variables like age, sex, injury mechanisms, types of injuries, etc. Data were presented as mean ± SD and proportions as appropriate.Results: Of the total 307,064 domestic injuries registered during 2000–2002, 77,500 cases (25.2%) were children. 70% of these children (54581 cases) were in age group of 1-5 years.The large fraction (58.8%) of injuries among children under 7 years of age went back to burn injuries. Cuts and lacerations were at the second level with 17.4%. 51% of injuries had contact with hot liquids. Of all children under 7 years of age injuries, 282 died, 86 were disabled, while the rest improved or being under treatment when recording data.Conclusion: Injuries, particularly burns (especially those who had contact with hot liquids that led into scald), are major public health problem that children under 7 years of age encounter. Therefore, it seems necessary to provide adequate plans to promote children under 7 years of age safety issues.
Leila Mohsenian; Mohamad Karim Khoramian; Sara Sadat Mazloom
Volume 6, Issue 4 , October 2018, , Pages 318-324
Abstract
Objective: To evaluate the prognostic value of arterial blood gas (ABG) indices, especially base excess (BE), regarding the severity of traumatic injury.Methods: A total number of 96 trauma patients with fractures of femur and pelvis were included in this study. Demographic characteristics and clinical ...
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Objective: To evaluate the prognostic value of arterial blood gas (ABG) indices, especially base excess (BE), regarding the severity of traumatic injury.Methods: A total number of 96 trauma patients with fractures of femur and pelvis were included in this study. Demographic characteristics and clinical information of samples were recorded. The results of ABG test and hemoglobin (Hb) were evaluated at two time intervals (on admission and 6 hours later). The outcome of the patients was evaluated at the end of the study (dead or alive). The ABG indices included O2 saturation (O2Sat), PH, PO2, PCO2, bicarbonate (HCO3) and base excess (BE). The mean of the hemodynamic and ABG indices were compared between those who were discharged and mortality cases. The confounders were compensated using a multivariate logistic regression model.Results: Overall 94 trauma patients with long and pelvic fractures were included. There were 69 (73.4%) men and 25 (26.6%) women among the patients with mean age of 37.43 ± 20.07 years. The mortality rate was 10 (10.6%). The most common mechanism of injury was motorcycle accident in 41 (43.6%) and car collision in 43 (45.7%) patients. We found that mortality was significantly associated with amount of FFP transfusion (p=0.005), but was not associated with amount of transfused packed cells (p=0.113). We also found that mortality was associated with lower BP after 6 hours of admission (p=0.001), higher HR on admission (p=0.036), lower HR after 6 hours (p=0.017), lower O2Sat on admission (p<0.001), higher PCO2 after 6 hours and lower BE on admission (p=0.025). Conclusion: The ABG indices including O2Sat, BE and PCO2 are considered prognostic determinants of outcome in trauma patients with long and pelvic fractures. These findings can be considered as fundamental studies to achieve new diagnostic methods.
Saber Azami-Aghdash; Hassan Abolghasem Gorji; Naser Derakhshani; Homayoun Sadeghi-Bazargani
Volume 7, Issue 4 , October 2019, , Pages 390-398
Abstract
Objective: To identify the barriers to and facilitators of the prevention of road traffic accidents (RTIs) in Iran. Methods: In this qualitative study 42 key stakeholders and experts in the field of traffic injuries in Iran were selected based on purpose and theoretical sampling to reach informational ...
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Objective: To identify the barriers to and facilitators of the prevention of road traffic accidents (RTIs) in Iran. Methods: In this qualitative study 42 key stakeholders and experts in the field of traffic injuries in Iran were selected based on purpose and theoretical sampling to reach informational saturation. Their views concerning barriers to and facilitators of the prevention of traffic injuries in Iran were studied using semi-structured interviews. Data were analyzed using Content Analysis method. Results: Five themes were identified: structural barriers, organizational barriers and planning, socio-cultural barriers, scientific barriers, and inter-sector barriers and 22 sub-themes were extracted. The lack of lead agency, which was among structural barriers, was selected as the main barrier. The five general facilitators included: sensitization of society and authorities, improving the resources and infrastructure (software and hardware), increasing the attention to safety of vehicles and roads, increasing the information and awareness, and use of expert manpower. The sensitization of society and authorities was selected as the most important facilitator. Conclusion: According to the key experts, the barriers of policy changes to prevent the RTIs are more numerous than its facilitators. Therefore, planning and paying more attention to removing these barriers and promoting the facilitators seems necessary to reduce RTIs. Having a lead agency in this regard should be the highest priority.
Shahram Paydar; Sedigheh Shokrollahi; Shahram Jahanabadi; Fariborz Ghaffarpasand; Zahed Malekmohammadi; Armin Akbarzadeh; Shahram Bolandparvaz; Hamid Reza Abbasi
Volume 1, Issue 1 , January 2013, , Pages 38-42
Abstract
Objective: To determine the epidemiology and pattern of emergency operating room workload in Nemazee hospital affiliated with Shiraz University of Medical Sciences, Shiraz, Iran.Methods: All surgical emergency operations which were performed in Nemazee hospital, Shiraz, Iran were collected over twelve ...
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Objective: To determine the epidemiology and pattern of emergency operating room workload in Nemazee hospital affiliated with Shiraz University of Medical Sciences, Shiraz, Iran.Methods: All surgical emergency operations which were performed in Nemazee hospital, Shiraz, Iran were collected over twelve months (September 2007 to September 2008). The data obtained included indications, presenting symptoms the services provided and the demographic information of the patients.Results: Overall number of recorded emergency operations in this cross sectional descriptive study was 3946, with males constituting 72% of the patients. The highest male/female ratio reported in trauma patients was 6.4:1 with the median age of 23 years, and the mean age of the operated patients was 27.8 years. Second to neurosurgery (19.64%) the general surgery was the busiest discipline in emergency operations (59.14%). Appendectomy (11.77%), double/triple lumen/central venous catheter insertion (9.4%), and fiber optic/rigid bronchoscopy (3.27%) were the commonest general surgical operations. Among trauma patients, neurotrauma was the commonest reason for operation (10%).Conclusion: Based on a new approach toward emergency operating room workload, in our country and centre, we showed that it is necessary to devote particular and individualized attention to the fields of agenda and hospital management of emergency operations. This is due to a high emergency operating room workload and its unique characteristics in our centre in contrast to other hospitals and departments. Although a decision making and operational strategy is recently seen to improve the quality and quantity of emergency services available to our patients, there is still a gap between present and optimal emergency healthcare which should be provided for our residents.
Hanieh Ahmadi; Zahra Alizadeh; Samad Karkhah; Mohammad Javad Ghazanfari
Volume 10, Issue 1 , January 2022, , Pages 40-43
Abstract
Ocular trauma is one of the most common causes of acquired blindness in children. The epidemiological parameters associated with ocular trauma vary in different populations, especially in children. The objective of this study was to assess the ocular trauma epidemiology in children less than ...
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Ocular trauma is one of the most common causes of acquired blindness in children. The epidemiological parameters associated with ocular trauma vary in different populations, especially in children. The objective of this study was to assess the ocular trauma epidemiology in children less than 18 years of age. In this crosssectional study, 145 children (under 18 years) with ocular trauma who referred to the emergency department of Bu-Ali-Sina Hospital in Sari, Iran were enrolled from November 2017 to January 2019. Of the participants, 57.9% were men, 70.4% had blunt trauma, 97.2% had a unilateral eye injury, and 54.5% had a right eye injury. The most risk factor for trauma was stationery (51.0%). Almost half of the patients (52.9%) had corneal injuries. The most trauma locations were at home (67.4%). Most patients (95.0%) had normal relative afferent pupillary defects. Blunt (52.6% vs. 47.4%) and penetrating (72.5% vs. 27.5%) traumas was higher in boys than girls (p=0.03). Most frequent part of eye injuries in blunt and penetrating traumas was related to the cornea (P=0.04). It seems that parents should have more supervision on children at home and give adequate education in using of stationery to school-age children by considering the results of present study.
Nasrin Mehri; Homayoun Sadeghi-Bazargani; Abdolrasoul Safaiean
Volume 5, Issue 1 , January 2017, , Pages 42-46
Abstract
Objective: To determine the epidemiological and clinical characteristics of hand and finger amputations in patients referring to a single center in northern Iran.Methods: This was a cross-sectional study conducted on 200 traumatic hand amputees hospitalized in Shohada Hospital in Tabriz, Northwestern ...
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Objective: To determine the epidemiological and clinical characteristics of hand and finger amputations in patients referring to a single center in northern Iran.Methods: This was a cross-sectional study conducted on 200 traumatic hand amputees hospitalized in Shohada Hospital in Tabriz, Northwestern Iran during a 1-year period in 2014. Data were collected through prospective interviews for variables such as demographic characteristics, accident time; exact anatomical site of amputation; reasons for amputation; amputation mechanism; and having attention deficit symptoms as well as activities causing attention deficit prior to the accident.Results: The vast majority of cases were men and women accounted for only 7.5% of injured cases. In 60.5% of cases, the accident occurred on the fingers of their active hand and fingers accounted for almost 95% of accidents. 85.8% of accidents occurred at work. 63.7% of accidents occurred in the evening. 63.67% of accidents occurred in the evening. Among hazardous occupations, agricultural occupations ranked the first followed by sugar cut and pressing jobs. It was found that 10% of the victims were injured while responding a mobile phone call and 3% of the victims reported that they were listening to music through headphones before the accident. Five percent of the participants reported a quarrel with a colleague and 11.5 % of them reported a quarrel with their employer prior to the accident.Conclusion: Amputations are of much importance in men working in given jobs such as agricultural and pressing. Distraction caused by mobiles, music and personal relations with others is considered of importance to be prevented during job. Risk levels for potential risk indicators need to be assessed through controlled studies.
Johannes Gossner
Volume 9, Issue 1 , January 2021, , Pages 48-49
Abstract
Ankylosing spinal disease (ASD) is a common clinical entity [1]. The main etiologies of ASD are diffuse idiopathic skeletal hyperostosis (DISH), ankylosing spondylitis and postoperative spinal fusion after removal of instrumentation. Because of the rigidity of the spine patients with ASD are prone to ...
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Ankylosing spinal disease (ASD) is a common clinical entity [1]. The main etiologies of ASD are diffuse idiopathic skeletal hyperostosis (DISH), ankylosing spondylitis and postoperative spinal fusion after removal of instrumentation. Because of the rigidity of the spine patients with ASD are prone to fractures even with minor trauma and unstable fracture patterns (distraction fractures and involvement of the posterior column) are common [1].
Mehrdad Amir-Behghadami; Masoumeh Gholizadeh; Ali Janati
Volume 8, Issue 1 , January 2020, , Pages 49-50
Abstract
Dear editor, Recently, we read with great interest the article authored by Jadidi et al. [1] that was entitled“Is emergency medical services (EMS) in Islamic Republic of Iran practical and efficient in facingEbola?” and published in Bull Emerg Trauma in 2019, in 7th volume ...
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Dear editor, Recently, we read with great interest the article authored by Jadidi et al. [1] that was entitled“Is emergency medical services (EMS) in Islamic Republic of Iran practical and efficient in facingEbola?” and published in Bull Emerg Trauma in 2019, in 7th volume and 3rd issue. First of all, wewould like to extend our gratitude to the authors of this article. Although the mentioned study wasappropriate and valuable, there was a fundamental flaw in the method, which has led to an ambiguous interpretation of the findings. Therefore, the purpose of this letter is to raise concerns about the data collection instrument and emphasize the importance of reporting its validity and reliability in crosssectional studies.
Farooq Ahmad Ganie; Mohd Lateef Wani; Abdul Gani Ahangar; Gholam Nabi Lone; Shyam Singh; Hafeezulla Lone; Shadab Nabi Wani
Volume 2, Issue 1 , January 2014, , Pages 52-54
Abstract
The aim of the current study was to determine the pattern, presentation and management of foreign body aspiration in our population. This prospective study comprised 55 patients with foreign body aspiration admitted to our department from January 2009 to December 2011. All patients underwent rigid ...
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The aim of the current study was to determine the pattern, presentation and management of foreign body aspiration in our population. This prospective study comprised 55 patients with foreign body aspiration admitted to our department from January 2009 to December 2011. All patients underwent rigid bronchoscopy under local or general anesthesia. The patients’ demographic information along with clinical characteristics and their outcome were recorded and reported. The mean age of the children was 13.3±3.6 years. There were 32 (58.2%) females and 23 (41.8%) males. The frequent symptom was an attack of chocking followed by cough. The predominant sign was wheezing. Rigid bronchoscopy was successful in removing foreign body from 52(94.5%) patients. Three (5.5%) patients who had undergone thoracotomy with bronchotomy needed exploration, after failure of bronchoscopy to remove the foreign body. There was no mortality in our series. Average hospital stay was 12 hours. It could be concluded that rigid bronchoscopy is modality of choice in management of foreign body aspiration especially in pediatric population.
Sarabjeet Kohli; Vikram Khanna; Nilesh Virani; Hemant Chaturvedi
Volume 4, Issue 1 , January 2016, , Pages 54-57
Abstract
Carpal injuries are uncommon and are mainly seen in the younger age group. The incidence is unclear as many of the cases go undiagnosed. A 22-year-old male patient coming to the hospital after road traffic accident with head, face and left wrist injury. After immediate primary management the patient ...
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Carpal injuries are uncommon and are mainly seen in the younger age group. The incidence is unclear as many of the cases go undiagnosed. A 22-year-old male patient coming to the hospital after road traffic accident with head, face and left wrist injury. After immediate primary management the patient was taken up for a definitive procedure 4 days after the injury. Scaphoid fracture was fixed with the help of Herbert’s screw via the dorsal approach. The base of the first metacarpal was fixed with the help of JESS fixator and the distal end radius was fixed with the help of K-wires. The scapholunate and lunato triquetral ligaments were repaired. The whole construct was stabilized with the help of an external fixator. Postoperative period was uneventful. The external fixator was removed after 4 weeks and patient had a good functional outcome with the patient related wrist evaluation score coming out to be 11 at the end of the third month. This uncommon case of Transradial, Trans scaphoid, transcapitate, and perilunate dislocation was managed successfully with no postoperative complications and a good functional outcome.
Abdolkhalegh Keshavarzi; Sina Kardeh; Amirhosein Pourdavood; Mana Mohamadpour; Maryam Dehghankhalili
Volume 6, Issue 1 , January 2018, , Pages 59-63
Abstract
Objective: To evaluate the lethal area 50 (LA50) and determinants of mortality in burn patients admitted to a single burn center.Methods: This retrospective cross-sectional study was conducted in a tertiary burn center affiliated with Shiraz University of Medical Sciences, Shiraz, Iran, during a 1-year ...
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Objective: To evaluate the lethal area 50 (LA50) and determinants of mortality in burn patients admitted to a single burn center.Methods: This retrospective cross-sectional study was conducted in a tertiary burn center affiliated with Shiraz University of Medical Sciences, Shiraz, Iran, during a 1-year period from 2015 to 2016. To determine prognostic factors in fatal burns, medical records of eligible burn patients were reviewed for demographic and clinical variables, as well as patient outcome. Also, LA50 was calculated using Probit analysis.Results: Overall 559 patients with the mean age of 27.2±23.65 years and including 343 (61.4%) males and 216 (38.6%) females were enrolled in this study. The average burn TBSA% was 31.38±24.41% (1-100%). Duration of hospital stay ranged from 1 to 67 days (15.11±10.64). With 93 expired patients, the mortality rate was calculated to be 16.6%. The total LA50 was 66.55% (58.4-79.3). Fire was the most common cause of burn injury.Conclusion: Compared to developed countries, in our burn center the LA50 and survival rate of burn patients are lower. This indicates an urgent need for prompt attention in order to improve current policies regarding this public health issue to reduce mortality.
Payam Roshanfekr; Mohammad-Reza Khodaie-Ardakani; Hossein Malek Afzali Ardakani; Homeira Sajjadi
Volume 7, Issue 1 , January 2019, , Pages 60-66
Abstract
Objective: To determine the prevalence and socio-economic disparity among victims with disabilities caused by RTAs in Iran as country with a high rate of accidents.Method: The source of data was the Iranian Multiple Indicator Demographic and Health Survey, a nationwide cross-sectional study. The ...
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Objective: To determine the prevalence and socio-economic disparity among victims with disabilities caused by RTAs in Iran as country with a high rate of accidents.Method: The source of data was the Iranian Multiple Indicator Demographic and Health Survey, a nationwide cross-sectional study. The sampling framework was based on the population and housing census for Iran in 2006. Provincial samples ranged from 400 to 6,400 households. The target sample was 3,096 clusters consisting of 2,187 urban and 909 rural clusters. In the present study, all but a few indicators are reported at provincial levels. Mortality indicators, accident and disability rates, low birth weight rate and young age at marriage rates are presented at the national level only. Logistic regression was performed to investigate the individual and family factors influencing RTAs that lead to disability in Iran.Results: The period prevalence (12 months) of road traffic accident disabilities (RTADs) in the total population of 111415 was 30.52 (95% CI: 21.13.41.64) per 100,000 individuals. Among those who had been injured during the year leading up to the study, the proportion of disabilities caused by RTAs was 31.67 (95% CI; 8.51.54.97) per 1000 pedestrians, 20.99 (95% CI: 13.37.30.75) per 1000 motorcyclists, 18.64 (95% CI: 7.71.29.57) per 1000 vehicle drivers. Multivariate logistic regression analysis showed that the risk of RTADs differed significantly in relation to age (AOR 50-59 vs. 0-9=10. 78, p-value:0.05); activity status (AOR unemployed vs. employed=4.72, p-value:0.001) and family income (AOR q2 vs. q1=0.37, p-value:0.048) of the victim.Conclusion: In addition to the risks associated with socio-economic groups, particularly vulnerable groups, RTADs have consequences which can lead to further marginalization of individuals, can affect their quality of life and damage the community as a whole.
Mauricio Gonzalez-Urquijo; Ernesto Cordoba-Chamorro; Susan Julieth Moreno-Diaz; Gabriel Fernando Mejia-Villate; Mario Alejandro Fabiani
Volume 10, Issue 2 , April 2022, , Pages 87-91
Abstract
We report two cases involving small-caliber gunshot wounds to the chest with embolization of the bullet which complete occluding arterial circulation into the left lower extremity. A 30-years-old and 19-years-old men suffered gunshots wound to the thorax and abdomen with subsequent arterial ...
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We report two cases involving small-caliber gunshot wounds to the chest with embolization of the bullet which complete occluding arterial circulation into the left lower extremity. A 30-years-old and 19-years-old men suffered gunshots wound to the thorax and abdomen with subsequent arterial embolisms into their left legs. Image studies revealed the left popliteal and femoral arteries occlusion by the missiles. Arteriotomies were auspiciously performed to retrieve the projectiles along with Fogarty catheters thrombectomies which conclude successful outcomes. At a 6 and 36 months’ follow-up, the patients were doing well without any vascular associated complications. Bullet embolization of the arterial or venous systems is a rare complication of penetrating gunshot injuries with diagnostic and therapeutic challenges. This complication’s suspicion should rise when there is a gunshot injury without an exit wound and with sudden pain or ischemia in an extremity. Individualized treatment should be urgently performed to avoid irreversible damage to the affected area.
Marta Ferreira; Jose Teixeira; Vitor Marques; Carlos Casimiro; Luis Filipe Pinheiro
Volume 1, Issue 2 , April 2013, , Pages 93-95
Abstract
The article reports a clinical case of a 39-year-old male patient who was admitted in the emergency room in shock. The clinical exams and additional tests identified a right massive hemothorax, without apparent etiological factors. He was submitted to an emergency right thoracotomy. A bulky varicose ...
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The article reports a clinical case of a 39-year-old male patient who was admitted in the emergency room in shock. The clinical exams and additional tests identified a right massive hemothorax, without apparent etiological factors. He was submitted to an emergency right thoracotomy. A bulky varicose formation in the diaphragmatic surface, with evident laceration and haemorrhage was identified. The article describes this case due to its rarity. The varicose formation was simply ligated and the evolution, as well as the outcome of this clinical case was uneventful.
Navid Kalani; Seyed Reza Habibzade; Roya Ghahremaninezhad; Ayoub Tavakolian; Naser Hatami; Saeed Barazandeh pour; Samaneh Abiri
Volume 8, Issue 2 , April 2020, , Pages 111-114
Abstract
Objective: To evaluate the diagnostic accuracy of history taking and physical examination in the patients with traumatic rib fractures. Methods: In a cross-sectional study, all patients with multiple traumas who referred to the emergency department were evaluated for the mechanism of injury, chief complaints, ...
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Objective: To evaluate the diagnostic accuracy of history taking and physical examination in the patients with traumatic rib fractures. Methods: In a cross-sectional study, all patients with multiple traumas who referred to the emergency department were evaluated for the mechanism of injury, chief complaints, vital signs and oxygen saturation. History taking and physical examination were performed according to Barbara Bates reference. Fracture was diagnosed based on chest x-ray results and CT scan, if needed. The results were analyzed by receiver operating characteristic (ROC) curves and area under the curve (AUC) analysis. Results: Isolated rib fractures of thoracic bones were found in 8 out of 99 subjects with mean age of 33.4±19.43 years. In the sensitivity analysis of history taking and physical exam tests, the highest sensitivity was chest tenderness and deformity with 100% sensitivity for each one and the lowest was for the dyspnea with 28.10%; however, the highest sensitivity was for dyspnea with 62.50% sensitivity; and pulmonary hearing aid and chest deformity were not specific (0%). For heart rate, AUC analysis was significant. Heart rate above 80/min was associated with 87.5% sensitivity and 62.5% specificity for rib fractures. Conclusion: Proper and physical examination and history taking can help to detect rib fractures with high sensitivity and specificity denoting to the importance of the issue; while, radiographic or surgical approval is required to diagnose rib fractures.
Luis Rafael Moscote-Salazar; Willem Guillermo Calderon-Miranda; Zenen Antonio Carmona-Meza; Hernando Raphael Alvis-Miranda; Nasly Zabaleta Churio; Gabriel Alcalá-Cerra; Andrés M. Rubiano
Volume 4, Issue 2 , April 2016, , Pages 113-115
Abstract
Balint’s syndrome is a rare neurological disorder associated with bilateral parieto-occipital damage which was described by Rezsö Bálint in 1909.The syndrome is manifested clinically by the presence of a hemispatial negligence. The lesion is usually inside parietooccipital region bilaterally in ...
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Balint’s syndrome is a rare neurological disorder associated with bilateral parieto-occipital damage which was described by Rezsö Bálint in 1909.The syndrome is manifested clinically by the presence of a hemispatial negligence. The lesion is usually inside parietooccipital region bilaterally in most cases but may also be compromised angular convolutions, the dorsolateral area of the occipital lobe as the superior parietal lobule. We herein report a 61-year-old man with traumatic brain injury who was diagnosed to have right parieto-occipital contusion in radiologic evaluation. Physical examination was consistent with Balint's syndrome. The patient was followed for 12 months post-injury and received 4-months of outpatient rehabilitation. Patient showed improvement of Balint’s syndrome 8 months after the starts of symptoms.
