Hosseinali Khalili; Amin Niakan; Fariborz Ghaffarpasand
Volume 4, Issue 4 , October 2016, , Pages 248-249
Lucas Bordón; Walter Paredes; Romina Pacheco; Noé Graneros; Carina Tolosa; Gustavo Galarza; Daniel Agustin Godoy
Volume 6, Issue 3 , July 2018, , Pages 253-256
Abstract
Scorpionism is the clinical picture resulting from the inoculation of scorpion venom. It is considered a major public health problem, especially in countries with low resources and tropical or subtropical climate. Poisoning can be fatal especially in the first hours due to respiratory and / or cardiovascular ...
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Scorpionism is the clinical picture resulting from the inoculation of scorpion venom. It is considered a major public health problem, especially in countries with low resources and tropical or subtropical climate. Poisoning can be fatal especially in the first hours due to respiratory and / or cardiovascular collapse. The compromise of the central nervous system (CNS) is infrequent but varied and complex, being able to be triggered due to multiple and different neurotoxic properties of the toxin. We report here a severe case of poisoning with cardiovascular and neurological compromise in an endemic region of Argentina. After cardiorespiratory stabilization, neurological deterioration is detected secondary to intracerebral hemorrhage that required surgery and multimodal neuromonitoring. The outcome was fatal due to multiple neurological and systemic complications. Scorpion sting poisoning is a true neurologic and neurosurgical life-threatening emergency.
Abolfazl Abbaszadeh; Akram Tehmasebi-Foolad; Asghar Rajabzadeh; Nasim Beigi-Brojeni; Leila Zarei
Volume 7, Issue 3 , July 2019, , Pages 284-291
Abstract
Objective: The present study was aimed at assessment of effect of application of Chitosan/Nano Selenium biofilm on infected wound healing in ratsMethods: Sixty-eight male Wistar rats were randomized into four groups of 17 animals each. In group I (Normal) the wounds were created with no infection. In ...
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Objective: The present study was aimed at assessment of effect of application of Chitosan/Nano Selenium biofilm on infected wound healing in ratsMethods: Sixty-eight male Wistar rats were randomized into four groups of 17 animals each. In group I (Normal) the wounds were created with no infection. In group II (MRSA), the wounds were infected with methicillin resistant Staphylococcus aureus (MRSA). In group III (MRSA/CHIT), animals with infected wounds were dressed with chitosan biofilm only. In group IV (MRSA/CHIT/NS), animals with infected wounds were dressed with Chitosan/Nano Selenium biofilm.Results: There were significant differences in comparisons of group IV and other groups, particularly in terms of cellular infiltration and neovascularization. During the study period, scores for neovascularization was significantly higher in group IV rats than other groups (P<0.05). Polymorphonuclear (PMN) and mononuclear (MNC) cell count and fibroblast cell proliferation in group IV were significantly higher than those of other experimental groups (P<0.05)Conclusion: Chitosan/Nano Selenium biofilm resulted in significant improvement in histopathological indices in full thickness infected wound healing.
Saptarshi Biswas; Boris Hristov
Volume 5, Issue 4 , October 2017, , Pages 303-306
Abstract
Traumatic iliac vessels injuries secondary to gunshot wound can often be fatal at the scene. One of the intriguing complications of vascular injuries is arteriovenous fistula. If the patient survives, these lesions may often not be diagnosed on first evaluation and patients may present with clinical ...
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Traumatic iliac vessels injuries secondary to gunshot wound can often be fatal at the scene. One of the intriguing complications of vascular injuries is arteriovenous fistula. If the patient survives, these lesions may often not be diagnosed on first evaluation and patients may present with clinical signs and symptoms years later. Open surgical repair can have prohibitive morbidity and mortality and endovascular techniques, an effective treatment alternative, can interrupt the abnormal vascular communication and preserve artery vein patency. We describe a unique case of iliac arteriovenous fistula (AVF), secondary to a bullet injury, identified by imaging studies and subsequently treated with endovascular surgery. In conclusion, traumatic AVF are rare. Traditional teaching mandates that zone III pelvic retroperitoneal hematomas secondary to penetrating trauma be explored.
Saeide Aghamohamadi; Katayoun Jahangiri; Amir Kavousi; Ardeshir Sayah Mofazali
Volume 6, Issue 4 , October 2018, , Pages 341-348
Abstract
Objective: To predict the accident mortality trend in next two decades in Iran.Methods: The study population comprised all deaths recorded in the system of registration and classification of causes of death of Ministry of Health and Medical Education of Iran during the years 2006 to 2015. The information ...
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Objective: To predict the accident mortality trend in next two decades in Iran.Methods: The study population comprised all deaths recorded in the system of registration and classification of causes of death of Ministry of Health and Medical Education of Iran during the years 2006 to 2015. The information was collected via death certificate, burial permit, and reporting forms. To forecast the trends of causes-of-death, Lee Carter model was employed in a demographic package 18.1 of R software version 3.3.1.Results: Based on the results, the highest percentage of all causes of death from accidents (in unintentional accidents) goes to transport accidents, and most top intentional accidents belonged to intentional self-harm. The trends of unintentional accidents in the whole population and both sexes have reduced from 2006 to 2035, such that the rate has reduced from 62.2 in 2006 to 12.1 per 100 thousand populations in 2035. It is anticipated that the causes of death due to intentional accidents with the rate of 8.86 in 2006, will be 1.89 (per 100,000 population) in the year 2035.Conclusion: Accident mortalities have a significant role in the deaths of Iranian population; therefore, to reduce the impact of accident mortality on society, a precise approach is needed to monitor the trends as well as preventing measures and increasing the safety standards.
sina jelodar; Ahmad Pourrashidi; Abbas Amirjamshidi
Volume 7, Issue 4 , October 2019, , Pages 416-419
Abstract
Sheno-occipital diastasis happens more frequently in children and is accompanied with neural and vascular injuries leading to a high rate of mortality. We present a rare type of clival fracture in a 21 years old man who could survive without any deficit even though the fracture extended widely from left ...
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Sheno-occipital diastasis happens more frequently in children and is accompanied with neural and vascular injuries leading to a high rate of mortality. We present a rare type of clival fracture in a 21 years old man who could survive without any deficit even though the fracture extended widely from left Asterion to the right orbit accompanied by widespread damage of the skull base air sinuses in 3D CT scan. To the best knowledge of the authors, neither this type of fracture, nor the clinical presentation, has been reported in relevant literature.
Taha Samad Soltany
Volume 6, Issue 1 , January 2018
Biplab Mishra
Volume 5, Issue 1 , January 2017, , Pages 63-66
Uldis Berzins; Gloria Maria Hohenberger; Ines Vielgut; Renate Krassnig; Bore Bakota; Franz Josef Seibert
Volume 7, Issue 1 , January 2019, , Pages 80-83
Abstract
Tarsal coalition is an often unrecognised cause of foot and ankle pain and represents a congenital osseous, cartilaginous or fibrous connection between two or more tarsal bones. Fractures in combination with tarsal coalitions are rarely described in the literature. We report the case of a 43-year-old ...
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Tarsal coalition is an often unrecognised cause of foot and ankle pain and represents a congenital osseous, cartilaginous or fibrous connection between two or more tarsal bones. Fractures in combination with tarsal coalitions are rarely described in the literature. We report the case of a 43-year-old male patient with a talocalcaneal coalition who sustained an open comminuted calcaneal fracture and a closed transverse cuboid fracture. Due to the asymptomatic tarsal coalition and the already firmly fixed subtalar joint, the patient was treated with open reduction and internal fixation (ORIF) with satisfactory outcomes instead of ORIF in combination with subtalar arthrodesis. Ten months after the trauma, the patient was satisfactory and could return to his regular work. There is currently no evidence for the gold standard treatment of calcaneal fractures with combined tarsal coalitions. Due to the satisfactory results of this case, authors conclude that in case with prior asymptomatic coalitions, singular ORIF without subtalar arthrodesis may be performed.
Saptarshi Biswas; Manick Saran
Volume 8, Issue 2 , April 2020, , Pages 129-131
Abstract
Laryngocele is not a common clinical entity that presents itself in a trauma setting. In the literature, there are currently two types of laryngocele, internal and mixed. Laryngocele may be congenital or acquired, and most often will present later in life. Traumatic laryngocele has only been reported ...
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Laryngocele is not a common clinical entity that presents itself in a trauma setting. In the literature, there are currently two types of laryngocele, internal and mixed. Laryngocele may be congenital or acquired, and most often will present later in life. Traumatic laryngocele has only been reported three times in the literature before. Herein, we report a rare case of a 22-year-old woman who presents with bilateral laryngocele secondary to sustained direct trauma. Neck Ct-scan revealed bilateral laryngocele being responsible for her dysphagia and dysphonia. She was monitored in the hospital for further exacerbation of her symptoms with feared airway occlusion in mind. On hospital day three, her dysphagia had resolved and her dysphonia had significantly improved. A second CT, revealed resolution of left laryngocele with the right decreased in size since the initial presentation. She was followed and had complete resolution of symptoms one week after the injury.
Mustafa Ozsoy; Ogun Ersen; Zehra Ozsoy; Sezgin Yilmaz; Yüksel Arıkan
Volume 6, Issue 2 , April 2018, , Pages 169-173
Abstract
The incidence of complex hepatobiliary injury secondary to blunt abdominal injuries varies between 3.4 and 5%. A 25-year old male patient underwent an urgent operation due to a motorcycle accident. During intraabdominal exploration, Grade 4 laceration was detected at the liver and bleeding was controlled ...
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The incidence of complex hepatobiliary injury secondary to blunt abdominal injuries varies between 3.4 and 5%. A 25-year old male patient underwent an urgent operation due to a motorcycle accident. During intraabdominal exploration, Grade 4 laceration was detected at the liver and bleeding was controlled through primary repair. In the postoperative seventh day, he was referred due to 1500 cc bile leakage from the drainage tube. During the operation, an extensive Kocher maneuver was done and the second part of duodenum was observed to be exposed to total avulsion from the head of the pancreas. Pancreatoduodenectomy was planned due to presence of ischemic changes in the second part of duodenum. In the postoperative follow-up, the abdomen was closed with a controlled abdominal closure procedure. The clinical findings of biliary tract injuries secondary to blunt abdominal injuries often manifest themselves late and early diagnosis is possible only with suspicion.
Zenon Pogorelic; Tonći Vodopić; Miro Jukić; Dubravko Furlan
Volume 7, Issue 2 , April 2019, , Pages 169-175
Abstract
Objective: To analyze outcomes of treatment and complications in children treated with elastic stable intramedullary nailing (ESIN) due to femoral fracture.Methods: From May 2002 until May 2018 case records of 103 patients (76 male and 27 female), with median age of 9 (range, 3-17) and follow-up of 92 ...
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Objective: To analyze outcomes of treatment and complications in children treated with elastic stable intramedullary nailing (ESIN) due to femoral fracture.Methods: From May 2002 until May 2018 case records of 103 patients (76 male and 27 female), with median age of 9 (range, 3-17) and follow-up of 92 months, who underwent ESIN because of displaced femoral fracture were retrospectively reviewed. The patient’s information including age, sex, side involved, trauma mechanism, type of fracture, associated injuries, neurovascular status, complications, operation time, duration of hospital stay, time to implant removal were analyzed. The surgical procedure implied a reposition of bone fragments and osteosynthesis with titanium elastic nails introduced through an incision over the lateral and medial border of the distal femoral metaphysis.Results: All patients achieved complete radiographic healing at a mean of 8.5 (range, 5-15) weeks. Nine (8.49%) postoperative complications were recorded: three entry site skin irritation, two cases of valgus angulation and one case of nail protrusion, re-fracture, Varus angulation and delayed union. All complications, except case of re-fracture and one valgus angulation, were treated conservatively, with no long term consequences for the patients. Two patients were re-operated. After removal of nails all patients recovered complete function of the extremity, without long term consequences.Conclusion: The ESIN for treatment of femoral fractures shows very good functional and cosmetic results. It allows an early functional and cast-free follow-up with a quick pain reduction. Because of the excellent objective and subjective results, the operative stabilization of femoral fractures with ESIN should be recommended to all pediatrics patients.
Rohat Ak; Ebru Ünal Akoğlu; Özge Ecmel Onur
Volume 4, Issue 3 , July 2016, , Pages 180-181
Nima Derakhshan; Fahim Baghban; Ali Haghnegahdar
Volume 1, Issue 4 , October 2013
MohammadBagher Shamsi; Siavash Vaziri; HamidReza Mozaffari; Maryam Mirzaei
Volume 8, Issue 3 , July 2020, , Pages 205-206
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.
Biplab Mishra; Mohit Kumar Joshi; Amulya Rattan; Subodh Kumar; Amit Gupta; Sushma Sagar
Volume 4, Issue 4 , October 2016, , Pages 250-251
Ankit Shukla; Varun Verma; Krishan Lal Kapoor; Bhanu Gupta; Rajesh Chaudhary
Volume 6, Issue 3 , July 2018, , Pages 257-261
Abstract
Blunt trauma abdomen is a very common entity but traumatic abdominal wall hernia is not that common. Herniation through abdominal wall usually occurs following trauma with seat belt, motor cycle, bicycle handle bar etc. Handlebar hernia is a less known variety of traumatic abdominal wall hernia as a ...
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Blunt trauma abdomen is a very common entity but traumatic abdominal wall hernia is not that common. Herniation through abdominal wall usually occurs following trauma with seat belt, motor cycle, bicycle handle bar etc. Handlebar hernia is a less known variety of traumatic abdominal wall hernia as a consequence of injury with handlebar of a bicycle. It is difficult to diagnose and one should have high index of suspicion. Management in traumatic abdominal wall hernia is individualized based on various factors. We herein present an interesting case of a14-year-old boy, who sustained blunt trauma abdomen from bicycle handlebar leading to triple herniation and perforation of the small bowel and hematoma of the mesentery. Patient was resuscitated and operated with a favorable outcome. Blunt trauma abdomen is a very common and the possibility of traumatic abdominal wall hernia should always be borne in mind.
Siamak Kazemi-Darabadi; Ramin Nayebzadeh; Amir Ali Shahbazfar; Faranak Kazemi-Darabadi; Ezzatollah Fathi
Volume 7, Issue 3 , July 2019, , Pages 292-299
Abstract
Objective: To compare the effects of curcumin and nanocurcumin oral supplementation on the muscle healing rate of an animal model of surgical muscle laceration.Methods: Thirty-two male adult rats were randomly divided into sham, control, curcumin, and nanocurcumin groups. Partial transection of the gastrocnemius ...
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Objective: To compare the effects of curcumin and nanocurcumin oral supplementation on the muscle healing rate of an animal model of surgical muscle laceration.Methods: Thirty-two male adult rats were randomly divided into sham, control, curcumin, and nanocurcumin groups. Partial transection of the gastrocnemius muscle was made in the right limb of the control and treatment groups. The sham and control groups received normal saline, curcumin group received 500 mg/kg of curcumin and nanocurcumin group received 100 mg curcumin-loaded nanomicelles orally every day. They euthanized two weeks later and the specimens were stained by hematoxylin-eosin (H&E) and Masson’s trichrome methods. Aspartate transaminase (AST) and creatine phosphokinase (CPK) were measured in blood samples.Results: The percentage of collagen fibers in the nanocurcumin group was significantly lesser than the control and curcumin groups (p<0.001). Muscle fiber regeneration in the treatment groups was significantly higher than the control group (p<0.001). The blood vessels of the nanocurcumin group were significantly more than other groups (p<0.001). Plasma AST had a significant difference in the control group compared to the sham and nanocurcumin groups (p=0.026). The plasma CPK level of the control group was also significantly higher than other groups (p<0.001).Conclusion: In conclusion, although oral curcumin supplementation has little effects because of its poor bioavailability, embedding it in nanoparticles could enhance its systemic effects in promoting the muscle healing process.
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.
Mahnaz Yadollahi; Narges Rahmanian; Kazem Jamali
Volume 6, Issue 4 , October 2018, , Pages 349-354
Abstract
Objective: To determine the indicators predicting the hospital mortality in pedestrian injured patients admitted to a level I trauma center in Southern Iran.Methods: This case control study was conducted in a Level-I trauma hospital in Shiraz. We selected all survived pedestrians who were admitted in ...
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Objective: To determine the indicators predicting the hospital mortality in pedestrian injured patients admitted to a level I trauma center in Southern Iran.Methods: This case control study was conducted in a Level-I trauma hospital in Shiraz. We selected all survived pedestrians who were admitted in the hospital with duration of admission more than 24 hours in one year from March 2016 to February 2017 as control group and compared with all non-survived pedestrian patients who expired in the hospital according to clinical from March 2012 to February 2017. Multiple logistic regression was performed to identify factors of hospital effect on pedestrian mortality and results expressed by Odds Ratios and their confidence intervals (CI) of 95%.Results: A total of 424 survived pedestrian injured patients were compare to 117 non-survived one. Their mean of survived and non-survived patients were 43.79 ± 19.37 and 56.76 ± 18.55 years respectively of which 361 (66.7%) and 180 (33.3%) were men and women, respectively. We found that the gender does not have any relation with hospital mortality (p=0.275). Followed by, age is in relevance with mortality. Glasgow Coma Scale(GCS), Injury Severity Score (ISS), blood urea nitrogen (BUN), platelet (PLT), potassium (K) and hemoglobin (Hb) are significant factor which are associated with mortality. According to logistic analysis GCS ≤8 (p
Hossein Hodjati; Hamed Ghoddusi Johari; Bizhan Khademi; Abdolkarim Rahmanian; Abtin Vahidi; Maryam Dehghankhalili
Volume 7, Issue 4 , October 2019, , Pages 420-423
Abstract
The aneurysms of the extracranial segment of the internal carotid artery are not common and are associated with severe neurologic deficits. They could be misdiagnosed with several lesion of the cervical region. We herein report a case of internal carotid artery aneurysm misdiagnosed as paraganglioma. ...
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The aneurysms of the extracranial segment of the internal carotid artery are not common and are associated with severe neurologic deficits. They could be misdiagnosed with several lesion of the cervical region. We herein report a case of internal carotid artery aneurysm misdiagnosed as paraganglioma. A 23-year-old man presented with progressive growing mass in right enlarging mass in the upper part of the neck below the angle of the mandible. The patient underwent surgery by the ear, nose, throat (ENT) surgeon through submandibular approach with impression of paraganglioma but severe pulsatile bleeding was encountered intraoperatively. Two vascular clamps were applied and the patient was transferred to the vascular ward. Computerized tomography (CT) angiogram revealed a huge aneurysm of the internal carotid artery in the extracranial segment with injured wall. After 2 days of medical therapy the patient was transferred to the operating room and the aneurysm was repaired using Dacrons. The patient had an uneventful hospital course and was asymptomatic after 1 year of follow-up. Precise preoperative assessment and evaluation with different modalities should be performed to avoid fatal complications. Surgery is a safe and effective method in experienced hands for repair of such aneurysms.
Best Reviewers
Volume 5, Issue 4 , October 2017
Golnar Sabetian; Fatemeh Aalinezhad; Mansoor Masjedi; Shahram Paydar
Volume 7, Issue 1 , January 2019, , Pages 84-87
Abstract
Pneumothorax as a complication of pleural catheter insertion could be very dangerous in patients under mechanical ventilation. In ICU patients, physical examination and supine chest x-ray (CXR) are poorly sensitive in diagnosis of pneumothorax. Moreover, CT scan has also disadvantages, such as radiation, ...
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Pneumothorax as a complication of pleural catheter insertion could be very dangerous in patients under mechanical ventilation. In ICU patients, physical examination and supine chest x-ray (CXR) are poorly sensitive in diagnosis of pneumothorax. Moreover, CT scan has also disadvantages, such as radiation, high cost, time consuming and need for patient transfer to radiology suit. In comparison to CXR and CT scan, ultrasonography is an available tool for early and rapid detection of this complication. In this study, we reported a 21-year-old woman, a victim of trauma, undergone pleural catheter insertion for drainage of hemothorax. She developed pneumothorax after the procedure. We discuss the usefulness of ultrasonography after pleural catheter insertion and concluded its adequacy and effectiveness in early diagnosis and also follow-up of pneumothorax.
Samer S. Hoz; Khatab Baban; Mohamad Sabah; Awfa Aktham; Alexis Rafael Narvaez-Rojas; Luis Rafael Moscote-Salazar
Volume 6, Issue 2 , April 2018, , Pages 174-177
Abstract
Pneumocephalus is defined as the presence of air in the intracranial cavity. In most cases, its evolution is asymptomatic and benign. Pneumocephalus post-surgery is a frequent complication of cranial surgery. We herein report delayed tension pneumocephalus after craniotomy for pituitary macroadenoma. ...
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Pneumocephalus is defined as the presence of air in the intracranial cavity. In most cases, its evolution is asymptomatic and benign. Pneumocephalus post-surgery is a frequent complication of cranial surgery. We herein report delayed tension pneumocephalus after craniotomy for pituitary macroadenoma. A 73-year-old man with recurrent pituitary macroadenoma underwent subtotal resection via subfrontal approach. The postoperative course was uneventful and the patients regained his normal daily living activities. Two months after the surgery the patients developed decreased level of consciousness and was diagnosed to suffer from tension pneumocephalus. Another craniotomy was performed and the dural defect at the base was repair with secondary graft and bone wax. The patient improved neurologically and had no pneumocephalus. The follow-up revealed good condition and outcome. In conclusion, tension pneumocephalus can occur at any time after craniotomy and post-surgical deterioration after resection of a giant pituitary tumor should be immediately assessed. There is not enough evidence to correlated tumor size with rates of pneumocephalus in this particular report, but further cases may need to be studied to come to a conclusion.