Mahnaz Yadollahi; Mojgan Behzadi Seyf-abadi; Forough Pazhuheian
Volume 7, Issue 2 , April 2019, , Pages 176-182
Abstract
Objective: To investigate the severity of injuries and the pattern of jaw and facial injuries in trauma patients and also to determine the predictors of the outcome in these patients.Methods: This cross-sectional study was conducted on 2697 patients with facial trauma who referred to trauma center in ...
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Objective: To investigate the severity of injuries and the pattern of jaw and facial injuries in trauma patients and also to determine the predictors of the outcome in these patients.Methods: This cross-sectional study was conducted on 2697 patients with facial trauma who referred to trauma center in Shahid Rajaee (Emtiaz) Hospital, Shiraz, Iran during 2010-2015. Injury severity score was determined through the conversion of injury codes of the International Classification of Diseases, tenth revision (ICD-10). Binary logistic regression by backward method was used to determine the partial effects of independent risk factors on death odds ratio.Results: The mean age of patients with maxillofacial injuries was 31.96 ± 15.80 years. The mean injury severity score (ISS) was 4.3 ± 4.4 and about 80% of the patients had an ISS between 1 and 8. Mandible fracture and ear injuries, respectively, were the most and the least prevalent types of maxillofacial injury. The odds ratio of death by motorcycle accident was 1.7 times higher than falling down in maxillofacial patients.Conclusion: Age, gender (male), ISS, and mechanism of injury were the significant predictors of mortality in the facial trauma patients. Mandible fracture and ear injury, respectively, were the most and the least prevalent types of maxillofacial injury. Our findings demonstrate the need for referral to the maxillofacial surgeon and maxillofacial surgery should be in connected with neurosurgical centers.
Uttam Chand Saini; Deepak Neradi; Deepak Kumar; Vikas Bacchal; Praveen Sodavarapu; Akshay Shetty
Volume 8, Issue 3 , July 2020, , Pages 207-208
Eduardo Smith Singares
Volume 5, Issue 3 , July 2017, , Pages 219-220
Best Reviewers
Volume 4, Issue 4 , October 2016
Daniel Burchette; Shreya Badhrinarayanan; Tim Hardwick; Rebecca Kampa
Volume 6, Issue 3 , July 2018, , Pages 262-266
Abstract
Bungee jumping is a recreational sport that is accepted to carry a level of risk. We present the case of a femoral fracture sustained during bungee jumping and examine the published literature on bungee jumping-related injuries. A previously well 31-year old female performed a 200ft bungee jump from ...
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Bungee jumping is a recreational sport that is accepted to carry a level of risk. We present the case of a femoral fracture sustained during bungee jumping and examine the published literature on bungee jumping-related injuries. A previously well 31-year old female performed a 200ft bungee jump from a crane. The apparatus was performed as expected and documented on the bystander video footage. As the bungee-cord became taut for the second time, there was an audible crack with accompanying scream. A closed, neurovascularly-intact injury was sustained to her right thigh. Radiographs revealed a comminuted mid-diaphyseal spiral femoral fracture, which was treated with intra-medullary nail fixation the following day. Following loss of position with proximal fragment flexion, the intramedullary nail was revised with open reduction and cerclage wiring 6 weeks later. Progression to clinical and radiological union was uneventful. Fatalities in bungee jumping are generally secondary to trauma as a result of equipment malfunction, user error, or related to pre-existing co-morbidity2. As no records are kept on bungee jumping injuries in the UK, reliable statistics are not available regarding the relative risks of this sport. We conclude that incidence of bungee jumping injuries is likely to remain low, but consider that improved recording of bungee jumping-related injury data will allow providers to give customers a realistic quantification of risk before engaging in this sport.
Milad Ahmadi Marzaleh; Rita Rezaee; Abbas Rezaianzadeh; Mahnaz Rakhshan; Gholamhassan Haddadi; Mahmoudreza Peyravi
Volume 7, Issue 3 , July 2019, , Pages 300-306
Abstract
Objective: To develop a national model for hospitals’ Emergency Department (ED) preparedness when facing radiation and nuclear incidents as well as nuclear terrorism in Iran.Methods: This analytical study was carried out in 2019 via Delphi technique in two rounds and prioritization using a pairwise ...
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Objective: To develop a national model for hospitals’ Emergency Department (ED) preparedness when facing radiation and nuclear incidents as well as nuclear terrorism in Iran.Methods: This analytical study was carried out in 2019 via Delphi technique in two rounds and prioritization using a pairwise questionnaire. Using classic Delphi technique and pairwise comparison, the components were given to 32 specialists in emergency medicine, nuclear medicine, medical physics, nuclear physics, radiobiology and radiation protection, health in disaster and emergency, and passive defense. Finally, the national model was developed by holding two focus group sessions.Results: The results from the two rounds of Delphi technique showed that 31 factors of preparedness were classified into three main classes, namely staff, stuff, and structure (system). Only three factors were excluded and the rest were agreed upon by the specialists. Given the weight of each class, it was found that staff preparedness and stuff preparedness had the highest and lowest priorities, respectively.Conclusion: Comprehensive preparedness requires enhancing and promoting cultural, social, economic, and political levels. Indeed, all preparedness levels should be promoted in alignment with each other. Hence, governments should align their policies to manage such incidents.
Suvashis Dash; Shibajyoti Ghosh
Volume 5, Issue 4 , October 2017, , Pages 311-313
Abstract
Diabetes insipidus is a disease charaterised by increased urine production and thrist. Neurogenic diabetes insipidus following head trauma,autoimmune disease and infection is quite common but diabetes insipidus following thermal burn injury is a rare complication.We should know about this complication ...
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Diabetes insipidus is a disease charaterised by increased urine production and thrist. Neurogenic diabetes insipidus following head trauma,autoimmune disease and infection is quite common but diabetes insipidus following thermal burn injury is a rare complication.We should know about this complication as its management need a comprehensive approach for satisfactory outcome. Thermal burn can cause different complications in early post burn period like electrolyte imbalance, dehydration, acute renal failure, but diabetes insipidus is a very rare and unusual complication that may come across in thermal burn. We should be aware about this condition to prevent and treat mortality and morbidity in burn patients. We have reported a case of transient diabetes insipidus in a patient of thermal burn in early post burn period. Patient was treated accordingly, leading to complete recovery.
Hossein Abdolrahimzadeh; Shahram Bolandparvaz; Hamid Reza Abbasi; Maryam Dehghankhalili; Shahram Paydar; Amirreza Dehghanian; Salar Hafez Ghoran; Mojtaba Asadollahi; Mehdi Zare
Volume 6, Issue 4 , October 2018, , Pages 355-362
Abstract
Objective: To determine the antimicrobial activity and entity of several local herbal plants against Acintobacters isolated from trauma patients admitted to a Level-I trauma center.Methods: The antibacterial activities of the Satureja bachtiarica oil and some selected Iranian medicinal plants (Artemisia ...
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Objective: To determine the antimicrobial activity and entity of several local herbal plants against Acintobacters isolated from trauma patients admitted to a Level-I trauma center.Methods: The antibacterial activities of the Satureja bachtiarica oil and some selected Iranian medicinal plants (Artemisia sieberi and Tanacetum dumosum belonging to the Asteraceae/Compositae; Salvia mirzayanii and Mentha mozaffarianii belonging to the Lamiaceae/Labiatae) were assayed on A. baumannii by microdilution and agar disc diffusion methods. Having obtained the acceptable antibacterial data, the shade-dried aerial parts of the plants were extracted by hydrodistillation method using Clevenger apparatus according to European pharmacopeia for 3 h. The analysis of S. bachtiarica essential oil accompanied by other herbal drug oils were performed by using GC/FID and GC/MS methods.Results: Outcomes revealed that the S. bachtiarica essential oil exhibited the potent antibacterial capability against Acinetobacter strains in comparison with Colistin, as a positive control. For S. bachtiarica, the growth inhibition zone and minimum inhibitory concentration (MIC) values were 21 mm and 0.5 mg/ml, while, for Colistin, the data were in order: 8 mm and 0.016 mg/ml. Consequently, GC/MS outcomes demonstrated that the major components of the essence were carvacrol (48.6%), followed by p-Cymene (16.6%), γ-terpinene (6.9%) and linalool (5.3%).Conclusion: Based on the considerable inhibitory activity against nosocomial infections by essential oil of S. bachtiarica, it could be considered as the suitable candidate in the food industry and pharmaceutical uses.
Saleh Mohebbi; Mohammad Aghajanpour
Volume 7, Issue 4 , October 2019, , Pages 424-426
Abstract
Nasopharyngeal masses in young males, first of all presumes Juvenile Nasopharyngeal Angiofibroma (JNA) in the mind, but other benign or malignant tumors should be considered for successful and adequate management of patients and also for minimizing morbidity from unnecessary interventions. We herein ...
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Nasopharyngeal masses in young males, first of all presumes Juvenile Nasopharyngeal Angiofibroma (JNA) in the mind, but other benign or malignant tumors should be considered for successful and adequate management of patients and also for minimizing morbidity from unnecessary interventions. We herein present a patient with nasopharyngeal carcinoma (NPC) mimicking JNA. The patient was presumed as JNA and underwent excessive surgical intervention and the final histopathology report was NPC. The aim of our case report is to highlight the importance of complete clinical examination and preoperative imaging in differentiating and ideal management of nasopharyngeal masses.
Satvinder Singh Bakshi
Volume 7, Issue 1 , January 2019, , Pages 88-89
Abstract
A 52-year-old male with type I diabetes since 16 years and chronic kidney disease since 10 years presented with pain and swelling of his right eye since 5 days associated with loss of vision since 3 days. On examination there was a blackish eschar in the right nasal cavity. Ophthalmologic examination ...
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A 52-year-old male with type I diabetes since 16 years and chronic kidney disease since 10 years presented with pain and swelling of his right eye since 5 days associated with loss of vision since 3 days. On examination there was a blackish eschar in the right nasal cavity. Ophthalmologic examination revealed chemosis, proptosis and complete ophthalmoplegia of the right eye along with complete loss of vision (Figure 1A). The patient underwent surgical debridement and orbital exenteration and was started on amphotericin B; however, his deteriorated and ultimately he succumbed to the illness 2 days later. The biopsy from the lesion was consistent with mucormycosis (Figure 1B).
Joseph J. Eid; Brian C. Cronin; Susan Seman
Volume 6, Issue 2 , April 2018, , Pages 178-180
Abstract
Trauma surgeons are currently encountering unusual adverse events after traumatic injuries. Ischemic optic neuropathy is a rare complication that may occur in trauma and burn patients that present in extremis and require massive resuscitation. A 29-year-old male patient sustains a penetrating injury ...
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Trauma surgeons are currently encountering unusual adverse events after traumatic injuries. Ischemic optic neuropathy is a rare complication that may occur in trauma and burn patients that present in extremis and require massive resuscitation. A 29-year-old male patient sustains a penetrating injury to the heart that required primary repair. He remained hemodynamically stable and required a limited amount of resuscitative fluids and products. Postoperatively, the patient develops acute painless bilateral loss of vision. These findings were consistent with posterior ischemic optic neuropathy. Ischemic optic neuropathy are uncommon entities that arise in trauma patients who require massive resuscitation. Given the limited treatment options, early diagnosis is key in limiting the hemodynamic insult to the optic nerve.
Saptarshi Biswas; Shekhar Gogna
Volume 7, Issue 2 , April 2019, , Pages 183-186
Abstract
Identification of any variant anatomy prior to surgery is as essential as having knowledge of normal anatomy. These surprises bring on many challenges along with as they can be fatal. We encountered a case of patient who succumbed down to an unrecognized rare mesenteric vasculature variant known as “Arc ...
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Identification of any variant anatomy prior to surgery is as essential as having knowledge of normal anatomy. These surprises bring on many challenges along with as they can be fatal. We encountered a case of patient who succumbed down to an unrecognized rare mesenteric vasculature variant known as “Arc of Buhler” (AOB) which is a persistent embryonic ventral anastomosis between the Celiac trunk and the Superior mesenteric artery. It is usually asymptomatic and found incidentally after evaluation for other pathologies. We herein report a pseudoaneurysm of Arc of Buhler being surgically managed after massive retroperitoneal hemorrhage. Unfortunately, the patient did not survive the procedure and passed away. AOB aneurysms present formidable risks to patients and diagnostic and therapeutic challenges to physicians. They are rare and require high index of suspicion on radiographic imaging. Present case reports underscore the importance of identifying it and treating it regardless of the size.
Mahmoudreza Peyravi; Milad Ahmadi Marzaleh
Volume 9, Issue 4 , October 2021, , Pages 204-205
Abstract
The new corona disease (COVID-19) is very contagious and features a high risk of vast outbreak and infection. The World Health Organization (WHO) declared a global public health emergency condition on 30 January 2020 and a universal epidemic afterwards by given its rapid epidemic worldwide (1). Iran ...
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The new corona disease (COVID-19) is very contagious and features a high risk of vast outbreak and infection. The World Health Organization (WHO) declared a global public health emergency condition on 30 January 2020 and a universal epidemic afterwards by given its rapid epidemic worldwide (1). Iran was amongst the first countries influenced by COVID-19. Iran’s health system was shocked by the fast and vast outbreak of the virus which made it impossible to take appropriate measures on the first days of COVID-19 outbreak for its management. However, Iran made maximal efforts returning to normal conditions. On the other hand, United States (US) sanctions contributed to the worsening of the conditions. The sanctions that mark the US’s economic and political war against Iran, date back to long time ago. These sanctions had indirect, adverse effects on the relief and rescue measures during the 2019 flood in Iran, as well (2). Sanctions are the perfect violation of humanitarian programs and are in conflict with the United Nations (UN) charter and the international human right declaration. Nonetheless, not only COVID-19 had no effects on the US’s perspectives and policies, but the sanctions have also been increased by the US in this period. In fact, the sanctions are the genuine manifestation of the US’s application of terrorism. These sanctions exert subtle physical, psychological, and mental effects on the people based on contribution to further spread of COVID-19.
Mukesh Meena; Karmbeer Singh; Sanjay Meena; Chetan Kumbhare; Dushyant Chouhan
Volume 8, Issue 3 , July 2020, , Pages 209-209
Mohit Kumar Joshi; Narendra Choudhary; Subodh Kumar; Dinesh Bagaria; Abhinav Kumar; Pratyusha Priyadarshini
Volume 6, Issue 3 , July 2018, , Pages 267-268
Seyedmohammad Seyedbagheri; Tabandeh Sadeghi; Majid Kazemi; Ali Esmaieli Nadimi
Volume 7, Issue 3 , July 2019, , Pages 307-313
Abstract
Objective: To determine the effects of the implementation of the telephone cardiopulmonary resuscitation (T-CPR) program on the outcomes of out-of-hospital cardiac arrest (OHCA).Methods: In this prospective study, Emergency Medical Service (EMS) dispatchers and all bystanders attending to patients with ...
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Objective: To determine the effects of the implementation of the telephone cardiopulmonary resuscitation (T-CPR) program on the outcomes of out-of-hospital cardiac arrest (OHCA).Methods: In this prospective study, Emergency Medical Service (EMS) dispatchers and all bystanders attending to patients with OHCA were included. The consensus sampling was carried out based on inclusion and exclusion criteria. The data collection tool was consisted of a demographic questionnaire for patients and bystanders accompanied by a checklist for CPR outcomes. Data were collected 6 months before and after the implementation of the T-CPR program and analyzed using SPSS version 18.Results: The results revealed that the percentages of successful and unsuccessful CPR cases before the implementation of the T-CPR program were 28.1% and 71.9%, respectively. However, in total, 32% and 67.8% of the CPR cases were successful and unsuccessful, respectively, after the implementation of the mentioned program. The survival rate increased from 56.5% in the pre-intervention phase to 72.4% in the post-intervention one. In terms of the outcomes, brain complications decreased from 40% in the pre-intervention phase to 32.1% in the post-intervention one; however, the Chi-square test showed no significant difference in terms of CPR outcomes in the two time periods (p=0.797).Conclusion: According to the results, it is recommended that T-CPR programs be developed and dispatchers be trained in the area of this research. The results could be regarded as a guide to EMS managers, healthcare professionals, and the basis for further studies on this subject.
Sara Saadat Mazloom; Mohamad Karim Khoramian; Leila Mohsenian
Volume 6, Issue 4 , October 2018, , Pages 363-366
Abstract
Spontaneous bacterial peritonitis (SBP) is a complication of liver cirrhosis with adverse effect on patient prognosis. Early diagnosis and treatment is highly important, especially in patients without remarkable manifestations. We designed this study to determine the prevalence of SBP among afebrile ...
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Spontaneous bacterial peritonitis (SBP) is a complication of liver cirrhosis with adverse effect on patient prognosis. Early diagnosis and treatment is highly important, especially in patients without remarkable manifestations. We designed this study to determine the prevalence of SBP among afebrile cirrhotic patients and identify high-risk subgroups in a referral center in southern Iran. This cross-sectional study evaluated all afebrile cirrhotic patients, admitted to the gastroenterology ward of Namazi hospital (affiliated with Shiraz University of Medical Sciences, Shiraz, Iran) over a 6-month period in 2017, for the presence and correlates of SBP. Demographic data, clinical findings, and comorbidities were recorded. Ascitic fluid white blood cells (WBC) count >500 and neutrophil count >250 indicated bacterial peritonitis. In total, 97 afebrile cirrhotic patients comprising of 63 (64.9%) men and 34 (35.1%) women were included. All patients had ascites and 89 (91.8%) had abdominal tenderness. Accordingly, abdominal distension was the top presentation. Confirmed etiologies or comorbidities such as HBS, HCV, and liver cancer or metastasis existed in 46 patients. Thirteen (13.4%) had SBP. The correlations of gender (p=0.331), decreased level of consciousness (p=0.145), tenderness (p=0.315). With regards to the type of presentations, only DLOC showed to be significantly higher in SBP negative patients (p=0.022, OR=0.09. 95%CI=0.01–0.62). Also, using binary logistic regression, the correlation of age with SBP was statistically non-significant (coefficient= ⎼0.013, p=0.595). Our findings indicated that routine paracentesis in all cirrhotic patients regardless of fever can help diagnose a number of potentially neglected patients and improve their outcome.
Neuza Soares; Ana Rita Parente; Clara Gomes; Rodrigo Pimentel
Volume 7, Issue 4 , October 2019, , Pages 427-428
Abstract
A 74-year-old female with diabetes mellitus type 2 was admitted to the emergency department due to fever, severe pain and oedema in her left forearm, with two days of evolution, after she has done gardening, but no clear history of trauma.
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A 74-year-old female with diabetes mellitus type 2 was admitted to the emergency department due to fever, severe pain and oedema in her left forearm, with two days of evolution, after she has done gardening, but no clear history of trauma.
Amir Mirhaghi; Mohsen Ebrahimi
Volume 7, Issue 1 , January 2019, , Pages 90-91
Abstract
Dear Editor, With great interest we have read the outstanding publication in the recent Bulletin of Emergency and Trauma issue by Ghafarypour-Jahrom et al. entitled "Validity and Reliability of the Emergency Severity Index and Australasian Triage System in Pediatric Emergency Care of Mofid Children's ...
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Dear Editor, With great interest we have read the outstanding publication in the recent Bulletin of Emergency and Trauma issue by Ghafarypour-Jahrom et al. entitled "Validity and Reliability of the Emergency Severity Index and Australasian Triage System in Pediatric Emergency Care of Mofid Children's Hospital in Iran" [1]. We bring your attention to the results concerning the reliability of Emergency Severity Index (ESI) in the mentioned study that may provide a new understanding to lead clinical practice in emergency department (ED). The study used Cohen kappa values to report inter-rater reliability of Level 1 to 5 are 0.833, 0.777, 0.520, 0.850 and 0.883. The reliability coefficient for level 4, 5 and 1 is almost perfect (> 0.80) which is reported in other literature too [2].
Saptarshi Biswas; Ronald Peirish
Volume 7, Issue 2 , April 2019, , Pages 187-191
Abstract
Bilateral inferior shoulder dislocations also known as luxatio erecta is an extremely rare injury that is commonly complicated with injuries to the humeral head, glenoid, clavicle, scapula, rotator cuff, capsule, ligaments, brachial plexus, axillary artery and vein. Our patient is a 66-year-old ...
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Bilateral inferior shoulder dislocations also known as luxatio erecta is an extremely rare injury that is commonly complicated with injuries to the humeral head, glenoid, clavicle, scapula, rotator cuff, capsule, ligaments, brachial plexus, axillary artery and vein. Our patient is a 66-year-old man who presented with both upper extremities above his head in a fixed abducted position after sliding down a ladder approximately 6-meters. Initial radiographs revealed both humeral heads to be located below the glenoid fossa with each humeral shaft parallel to the scapular spines. Computed tomography (CT) revealed a right Hill-Sachs compression fracture (posterolateral humeral head) with a bony Bankart fracture (anteroinferior glenoid) and an avulsion fracture of the left acromion. Successful closed reduction was obtained. Upon follow up, bilateral rotator cuff tears were suspected and confirmed with magnetic resonance imaging (MRI). Early recognition, treatment and follow-up is essential to minimize complications.
Ali Jadidi; Behrooz Irannejad; Paria Bahrami; Yaser Moradi; Mohammadreza Zaker Tarzam
Volume 7, Issue 3 , July 2019, , Pages 315-319
Abstract
Objective: To evaluate the efficacy and preparedness of Emergency Medical Services (EMS) in Islamic Republic of Iran to face Ebola.Methods: The present study is cross-sectional and somehow descriptive. We used a standard questionnaire that was designed by “center for disease control and prevention”. ...
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Objective: To evaluate the efficacy and preparedness of Emergency Medical Services (EMS) in Islamic Republic of Iran to face Ebola.Methods: The present study is cross-sectional and somehow descriptive. We used a standard questionnaire that was designed by “center for disease control and prevention”. This questionnaire was captioned “Emergency Medical Services (EMS) checklist for Ebola preparedness”. We collected a lot of data by studying that questionnaire and every manager in every province of Iran were informed about that info in 2016. This data was analyzed by using SSPP software version 16.Results: Findings have showed the average score related to preparation level of EMS in facing Ebola in Iran was 63.73±12.77 percent. There was no significant difference between the country regions regarding the preparedness of to detect (p=0.975), protect (p=0.275) and respond (p=0.344) to ebola outbreaks.The highest score had been achieved by region number 5 and the lowest score belonged to region number 7.Conclusion: Although the acquired average score in this study is higher than standards, considering the increased threat of breaking out biologic threats especially Ebola infection, using and practicing some measures in order to enhance preparation level of Emergency Medical Services counter this infection and similar infectious diseases is inevitable.
Keyvan Eghbal; Abbas Rakhsha; Arash Saffarrian; Abdolkarim Rahmanian; Hamid Reza Abdollahpour; Fariborz Ghaffarpasand
Volume 6, Issue 4 , October 2018, , Pages 367-371
Abstract
Atlantoaxial rotatory subluxation (AARS) is rarely occurred in adults with trauma as the most common cause. In type A and B it is usually managed with close reduction and external brace; however, in nonresponsive cases, surgical interventions might be needed. Our patient is a 21-year-old man with neck ...
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Atlantoaxial rotatory subluxation (AARS) is rarely occurred in adults with trauma as the most common cause. In type A and B it is usually managed with close reduction and external brace; however, in nonresponsive cases, surgical interventions might be needed. Our patient is a 21-year-old man with neck pain and torticollis after a car turn- over. There was C1-C2 rotatory subluxation with left side locked facet and C1 rotation about 40 degrees relative to C2 on computed tomography without evident of ligamentous injury in magnetic resonance imaging (MRI). However, during the first 48 hours, two tries of close reduction using Gardner cervical traction under fluoroscopy were failed. Thus, the patient underwent open reduction of the subluxation and atlantoaxial fixation (Harm’s technique) with subsequent relief of pain and torticollis. This a rare case of traumatic AARS type A with unilateral locked facet joint in an adult patient which needed surgical manipulation for reduction. The management of the AARS in adults should be individualized in each patient.
Mehrdad Amir Behghadami; Ali Janati
Volume 7, Issue 4 , October 2019, , Pages 429-430
Abstract
Dear editor, Recently a study titled, “A Productive Proposed Search Syntax for Health Disaster Preparedness Research”, was worked by Rastegarfar et al. in the Bulletin of Emergency And Trauma [1]. First of all, we would like to thank the editors that help to appear review study. In addition, ...
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Dear editor, Recently a study titled, “A Productive Proposed Search Syntax for Health Disaster Preparedness Research”, was worked by Rastegarfar et al. in the Bulletin of Emergency And Trauma [1]. First of all, we would like to thank the editors that help to appear review study. In addition, we would like to extend our appreciation to the authors of this article. Review studies are considered as studies with the highest level of evidence that play an important role in evidence-based decision making [2]. The results of the mentioned study are an interesting; however, we believe that there are some questions regarding the study, which, we would like to present. These questions, if replied, will only apply to improve the quality of the current study and similar studies in the near future.
Abhay Tyagi; Richa Aggarwal; Kapil Dev. Soni; Anjan Trikha
Volume 7, Issue 2 , April 2019, , Pages 192-195
Abstract
Fat embolism syndrome is a rare but fatal complication seen commonly in patients with polytrauma. Its earliest manifestation is hypoxemia due to deposition of fat globules in pulmonary circulation which can progress to severe acute respiratory distress syndrome, the treatment of which is mainly supportive. ...
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Fat embolism syndrome is a rare but fatal complication seen commonly in patients with polytrauma. Its earliest manifestation is hypoxemia due to deposition of fat globules in pulmonary circulation which can progress to severe acute respiratory distress syndrome, the treatment of which is mainly supportive. We describe the case of a 17-year-old male who was admitted in our intensive care unit (ICU) for severe hypoxemia due to fat embolism. He had burst fracture of 5th lumbar vertebra with canal compromise along with other fractures. Failing conventional ventilation, the patient was placed in prone position taking proper precautions in positioning giving due consideration to his unstable lumbar spine. There was no neurological insult and in the next two days, he was weaned off from the ventilator. Though prone position is relatively contraindicated in patients with unstable spine, we employed early prone positioning taking adequate precautions, the benefit of which we believe outweighed the risk.
Mohammad Moshiri; Zahra Ataee; Parastoo Rahimi; Elham Ansari; Leila Etemad
Volume 7, Issue 3 , July 2019, , Pages 320-323
Abstract
Ileus is a very rare complication of methamphetamine (MET) intoxication. We herein report a 15-year-old non-addict girl who ingested about 5 gr of MET. She suffered from bowel obstruction manifestations. She was treated by intravenous metoclopramide and erythromycin. On next morning, she became restlessness ...
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Ileus is a very rare complication of methamphetamine (MET) intoxication. We herein report a 15-year-old non-addict girl who ingested about 5 gr of MET. She suffered from bowel obstruction manifestations. She was treated by intravenous metoclopramide and erythromycin. On next morning, she became restlessness with tachycardia and sweeting that was treated by intravenous diazepam. Abdominal-pelvic computerized tomography (CT) scan confirmed generalize dilatation in small intestine and more prominent in colon with no ischemia or mechanical obstruction. It also showed some hyperdense collections in ascending colon, sigmoid and rectum. MET was detected in her urine. On the third day, the bowel obstruction signs resolved. On fourth day, the prokinetic drugs were discontinued and whole bowel irrigation by polyethylene-glycol was performed. She passed the drug packages, and was discharged in well condition on fifth day. MET intoxication can induce ileus, specially, in the higher doses of MET and physicians should mention this rare MET presentation.
