Syed Tajuddin Syed Hassan; Jamaludin Husna; Mohd Riji Haliza; Abdul Raman Rosna; Wan Fei Khaw
Volume 1, Issue 4 , October 2013, , Pages 137-138
Mehdi Ayaz; Hamid Bahadoran; Peyman Arasteh; Abdolkhalegh Keshavarzi
Volume 2, Issue 4 , October 2014, , Pages 141-145
Abstract
Objective: To compare outcome of patients with burns covering less than 15% of total body surface area(TBSA) undergoing early excision and grafting or delayed skin grafting.Method: This was a non-randomized clinical trial including 54 patients with less than 15% TBSA burn referring to Ghotboddin Hospital ...
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Objective: To compare outcome of patients with burns covering less than 15% of total body surface area(TBSA) undergoing early excision and grafting or delayed skin grafting.Method: This was a non-randomized clinical trial including 54 patients with less than 15% TBSA burn referring to Ghotboddin Hospital of Shiraz. They were assigned to two study groups, each group including 27 patients: the early excision and grafting group (EEG group) and the delayed grafting group (DG group). Patients were followed postoperatively for 6 months. Hospital stay, graft success rate, itching score and scar formation during 6 months of follow-up were recorded and compared between two study groups.Results: During the study 1 patientwas lost to follow-up inearly excision and grafting group. Baseline characteristics were comparable between two study groups. The graft success rate was significantly higher in those patients who underwent early excision and grafting when compared to delayed grafting group (96.88% vs. 92.88%; p=0.033). However the length of hospital stay, itching and scar scores were comparable between two study groups after 6 months of follow-up.Conclusion: In patients with burns covering less than 15% TBSA, early excision and grafting is associated with higher graft success rates compared to the delayed excision and grafting. Howeverlength of hospital stay, itching and scar formation is comparable between the two techniques.
Daniel Agustin Godoy; Pablo David Guerrero Suarez; Luis Rafael Moscote-Salazar; Mario Di Napoli
Volume 5, Issue 3 , July 2017, , Pages 143-151
Abstract
Intracranial hypertension (IH) is one of the final pathways of acute brain injury. In severe traumatic brain injury (sTBI), it independently predicts poor outcomes. Its control represents a key aspect of the management. Lack of response to conventional therapies signals a state of ‘’refractory ...
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Intracranial hypertension (IH) is one of the final pathways of acute brain injury. In severe traumatic brain injury (sTBI), it independently predicts poor outcomes. Its control represents a key aspect of the management. Lack of response to conventional therapies signals a state of ‘’refractory IH’’, with an associated mortality rate of 80-100%. In such cases, hypothermia, barbiturates at high doses (BBT), decompressive craniectomy (DC), and extreme hyperventilation are utilized. However, none of them has proven efficacy. Indomethacin (INDO), a non-steroidal anti-inflammatory drug, may be an option with an acceptable safety profile and easy to administer. Reported series showed encouraging results. We herein present a case of refractory IH after sTBI in which INDO was utilized. In refractory IH, INDO can help to decrease ICP and improve cerebral perfusion pressure. However, it requires administration under strict protocol since it’s not free of adverse effects after withdrawal.
Omid Yousefi; Shahab Ghazi Mirsaiid; Pouria Azami; Ghazal Karimi; Arash Mani; Amin Niakan; Hosseinali Khalili
Volume 10, Issue 4 , October 2022, , Pages 157-164
Abstract
Objective: To study a Boswellia and ginger mixture on the memory dysfunction of the mild traumatic braininjury (mTBI) patients.Methods: Patients with mTBI were asked about memory impairment following the injury. One hundred mTBIpatients were visited and assessed using an auditory-visual learning test ...
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Objective: To study a Boswellia and ginger mixture on the memory dysfunction of the mild traumatic braininjury (mTBI) patients.Methods: Patients with mTBI were asked about memory impairment following the injury. One hundred mTBIpatients were visited and assessed using an auditory-visual learning test (AVLT) questionnaire. By usingrandom permuted blocks, patients were given the Memoral (a mixture of 360 mg of Boswellia and 36 mg ofginger) or placebo and were asked to consume it for a month. Patients were assessed one and three monthsafterward using the second and third steps of AVLT, respectively.Results: One hundred patients were included in the study and divided into control and intervention groups.The mean age of the patients was 36.83±14.71, and there were no significant differences between the twogroups (p=0.41). There were no statistically significant differences in the baseline scores of different AVLTparameters between the two groups. All patients had improvements in different parameters after three months.But some factors include the scores’ change in total learning, retroactive interference score, forgetting rate,and net positive score were significantly higher in treatment groups at one-month and three-month follow-upscompared to the placebo group. In contrast, word span and hit parameters had the same pattern of improvementin both groups.Conclusion: The herbal medication can have a satisfactory effect on eliminating post-mTBI memory dysfunctionwhile having no considerable adverse effects. The effect of these components can also be sustained after a twomonthtimeframe. These results may assist patients to have less mental involvement.
Leili Abedi Gheshlaghi; Hamid sharifi; Mehdi Noroozi; Mohsen Barouni; Homayoun Sadeghi-Bazargani
Volume 9, Issue 4 , October 2021, , Pages 169-177
Abstract
Objective: To investigate the quality of life (QOL) of injured motorcyclists and associated factors in a period of three months after the accident. Methods: In the present study, we were included 190 injured motorcyclists who admitted to two referral specialized hospitals (Emam Reza and Shohada) in Tabriz, ...
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Objective: To investigate the quality of life (QOL) of injured motorcyclists and associated factors in a period of three months after the accident. Methods: In the present study, we were included 190 injured motorcyclists who admitted to two referral specialized hospitals (Emam Reza and Shohada) in Tabriz, between June 2018 and January 2019. All injured motorcyclists were contacted through the telephone one and 171 of them (90%) three months after their accident to complete an EQ-5D-3L questionnaire. The baseline measurements were gathered by using face to face interviews in the hospitals. The QOL score could vary between 1 and 3. The higher score showed a lower QOL. Results: The injured motorcyclist’s QOL score was relatively better in three months after the accident (mean±Standard Deviation (SD): 1.78±0.51) in comparison with their status a month after the accident (2.15±0.65) (p <0.001). The multivariable model showed that individuals with pelvis injuries (Coef: 0.29, (95% CI: 0.16, 0.42), p=0.001) and knee injuries (Coef: 0.26, (95% CI: 0.10, 0.42), p=0.001), experienced a higher QOL score. Also, those whose accident had happened in rainy weather experienced higher QOL score (Coef: 0.33, (95% CI: 0.12, 0.53), p=0.001). The patients who were in an accident with a vehicle were experienced a better QOL than others (Coef: -0.26, (95% CI: -0.43, -0.09), p=0.002). Conclusion: The assessment of three-months post-accident showed that the QOL score of the motorcyclists was reduced. It is recommended that the QOL of patients should be improved in hospital discharge victims.
Mohammad Amin Mahdiyar; Mohammad Taghi Karimi; Hamid Namazi; Hussein Malekjamshidi
Volume 11, Issue 4 , October 2023, , Pages 173-177
Abstract
Objective: This study aimed to compare the outcomes of fixing scapholunate with pins and screws in parallel,convergent, and divergent orientations.Methods: In this computer simulation study, the CT scan images of a healthy subject wereused to construct a 3D model of the wrist joint using MIMICS software. ...
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Objective: This study aimed to compare the outcomes of fixing scapholunate with pins and screws in parallel,convergent, and divergent orientations.Methods: In this computer simulation study, the CT scan images of a healthy subject wereused to construct a 3D model of the wrist joint using MIMICS software. The imposed force to scaphoid and3D model lunate bones, as well as the scapholunate angle and distance, were compared in different surgicaltechniques using parallel, divergent, and convergent pins and screws.Results: In the absence of external force, the imposed stress applied to the scaphoid and lunate bones in casesof parallel pins and screws were 7.5MPa, 5.08MPa (pins), 1.134MPa, and 1.151MPa (screws), and 10.90MPa,10.90MPa (pins), 9.7MPa, and 34.1MPa (screws) for 50N flexion force. The imposed stress in this approach issignificantly lower compared to other interventions. Better outcomes were seen regarding scapholunate angleand scapholunate distance in using parallel pins or screws as well.Conclusion: In conclusion, implementing parallel pins and screws for scapholunate fixation had better resultsin terms of achieving carpal stability in scapholunate dissociation. However, fixation with pins and screwsshowed a statistically significant difference. Furthermore, a wide range of motion exercises with no additionalforces can be used in the rehabilitation of patients undergoing this surgery.
Amir Khorram-Manesh; Johan Berlin; Eric Carlström
Volume 4, Issue 4 , October 2016, , Pages 186-196
Abstract
The aim of the current review wasto study the existing knowledge about decision-making and to identify and describe validated training tools.A comprehensive literature review was conducted by using the following keywords: decision-making, emergencies, disasters, crisis management, training, exercises, ...
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The aim of the current review wasto study the existing knowledge about decision-making and to identify and describe validated training tools.A comprehensive literature review was conducted by using the following keywords: decision-making, emergencies, disasters, crisis management, training, exercises, simulation, validated, real-time, command and control, communication, collaboration, and multi-disciplinary in combination or as an isolated word. Two validated training systems developed in Sweden, 3 level collaboration (3LC) and MacSim, were identified and studied in light of the literature review in order to identify how decision-making can be trained. The training models fulfilled six of the eight identified characteristics of training for decision-making.Based on the results, these training models contained methods suitable to train for decision-making.
Masoumeh Nouri; Marzieh Ebrahimi; Tooran Bagheri; Mohammad Javad Fatemi; Arash Najafbeygi; Shirin Araghi; Maryam Molaee
Volume 6, Issue 3 , July 2018, , Pages 195-200
Abstract
Objective: To compare the healing effects of dried and acellular human amniotic membrane and Mepitel for coverage of split-thickness graft donor site (STGDS). Methods: Twenty patients who underwent STGDS regeneration surgery in identical anatomic regions were enrolled in this randomized controlled ...
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Objective: To compare the healing effects of dried and acellular human amniotic membrane and Mepitel for coverage of split-thickness graft donor site (STGDS). Methods: Twenty patients who underwent STGDS regeneration surgery in identical anatomic regions were enrolled in this randomized controlled clinical trial conducted in Hazrate Fatemeh hospital (Iran). Patients were randomly assigned in 3 groups of wound dressing; group A by Mepitel, group B AmiCare (Dried amniotic membrane) and group C OcuReg-A (Acellular amniotic membrane). Re-epithelization rate (healing time), pain sensation, scar formation and infection rate were assessed till complete healing was achieved.Results: Our results showed no significant difference between Amicare, OcuReg-A and Mepitel in the features analyzed by us including: Re-epithelization rate (healing time) P value; 0.573, Pain sensation P value: day 4 th: 0.131, day8 th: 0.93 and day 12 th: 0.365, Scar formation P value>0.05 and Infection rate.Conclusion: Our findings confirmed the safety and efficacy of AmiCare (dried amniotic membrane) and OcuReg-A (Acellular amniotic membrane) in treatment of split-thickness donor site in comparison with Mepitel as a standard wound dressing.Trial registration number: IRCT201511118177N12.
Saber Azami-Aghdash; Homayoun Sadeghi-Bazarghani; Ramin Rezapour; Mahdiyeh Heydari; Naser Derakhshani
Volume 7, Issue 3 , July 2019, , Pages 212-222
Abstract
Objective: To compare the stewardship of road traffic accidents (RTIs) prevention in three pioneer countries and three similar ones to Iran.Methods: In this descriptive comparative study, the United States of America, Sweden, and Brazil as the pioneer countries in RTIs prevention were compared to the ...
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Objective: To compare the stewardship of road traffic accidents (RTIs) prevention in three pioneer countries and three similar ones to Iran.Methods: In this descriptive comparative study, the United States of America, Sweden, and Brazil as the pioneer countries in RTIs prevention were compared to the India, Pakistan, and Turkey as the countries socioeconomically similar to Iran. Embase, PubMed, Scopus, IranDoc, IranMedex, SID, and MagIran were searched. Also a hand search conducted on websites and search engines using related keywords.Results: In the pioneer countries in RTIs prevention there was a delegation to a particular organization. In the other three countries a part of the Ministry of Transportation had the overall responsibility of RTIs. In Iran there was uncertainty in the stewardship of RTIs prevention. There was little evidence on the role and activities of health systems in RTIs prevention.Conclusion: It seems necessary to define a lead agency organization on RTIs prevention in Iran with sufficient authority and resources. This study also recommends conducting reliable studies to investigate the possible roles that the health system of a country can assume regarding the RTIs prevention.
Hassan Araghizadeh; Mahmoudreza Peyravi; Simintaj Sharififar; Milad Ahmadi Marzaleh
Volume 8, Issue 4 , October 2020, , Pages 218-223
Abstract
Objective: The present study aimed at codifying a native model of civil-military coordination (CIMIC) in natural disasters in Iran. Methods: This manuscript is a part of a larger study. The present cross-sectional study was conducted in 2019 using a two-stage Delphi technique. The factors confirmed by ...
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Objective: The present study aimed at codifying a native model of civil-military coordination (CIMIC) in natural disasters in Iran. Methods: This manuscript is a part of a larger study. The present cross-sectional study was conducted in 2019 using a two-stage Delphi technique. The factors confirmed by the technique were prioritized via a pairwise questionnaire. In doing so, 24 elites and experts in civil-military coordination were presented with the indicators in the course of classic Delphi technique and pairwise comparison. At the end, the nationalized model was finalized by sending the model to ten experts and asking their ideas. Results: The results obtained from the two rounds of Delphi indicated that 36 coordination factors could be classified into three primary classes of staff, stuff, and system. All factors were confirmed by the experts. Considering the weight of each class, “staff” and “stuff” classes were considered to be the highest and lowest priorities, respectively. Conclusion: Application of the coordination factors in the context of military and civil organizations leads to a better response to natural disasters. The organizations in charge of responding to disasters should be obliged to apply this model in the highest organizational commitment level as the final goals of disaster management. The results of the present study can be applied for codification of a comprehensive plan for assessing the civil-military coordination in natural disasters.
Ali Mehrshad; Mohammad Shahraki; Shahin Ehteshamfar
Volume 5, Issue 4 , October 2017, , Pages 231-239
Abstract
Objective: To determine the effects of methylprednisolone-laden hydrogel loaded into a chitosan conduit on the functional recovery of peripheral nerve using a rat sciatic nerve regeneration model was assessed.Methods: 10-mm sciatic nerve defect was bridged using a chitosan conduit (CHIT/CGP-Hydrogel) ...
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Objective: To determine the effects of methylprednisolone-laden hydrogel loaded into a chitosan conduit on the functional recovery of peripheral nerve using a rat sciatic nerve regeneration model was assessed.Methods: 10-mm sciatic nerve defect was bridged using a chitosan conduit (CHIT/CGP-Hydrogel) filled with CGP-hydrogel. In authograft group (AUTO) a segment of sciatic nerve was transected and reimplanted reversely. In methylprednisolone treated group (CHIT/MP) the conduit was filled with methylprednisolone-laden CGP-hydrogel. The regenerated fibers were studied within 16 weeks after surgery.Results: The behavioral, functional and electrophysiological studies confirmed faster recovery of the regenerated axons in methylprednisolone treated group compared to CHIT/Hydrogel group (p<0.05). The mean ratios of gastrocnemius muscles weight were measured. There was statistically significant difference between the muscle weight ratios of CHIT/MP and CHIT/Hydrogel groups (p<0.05). Morphometric indices of regenerated fibers showed number and diameter of the myelinated fibers were significantly higher in CHIT/MP than in CHIT/Hydrogel group. Conclusion: Methylprednisolone-laden hydrogel when loaded in a chitosan conduit resulted in improvement of functional recovery and quantitative morphometric indices of sciatic nerve.
Mojtaba Keikha; Mohammad Salehi-Marzijarani; Reihane Soldoozi Nejat; Hojat sheikh Motahar Vahedi; Seyed Mohammad Mirrezaie
Volume 6, Issue 4 , October 2018, , Pages 271-278
Abstract
Objective: To perform a diagnostic accuracy of the rapid ultrasound in shock (RUSH) to diagnose the etiology of undifferentiated shock in patients presenting to the emergency department (ED).Methods: We searched the Medline via PubMed, Scopus, and ISI Web of Knowledge till July 2017. Two independent ...
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Objective: To perform a diagnostic accuracy of the rapid ultrasound in shock (RUSH) to diagnose the etiology of undifferentiated shock in patients presenting to the emergency department (ED).Methods: We searched the Medline via PubMed, Scopus, and ISI Web of Knowledge till July 2017. Two independent reviewers screened studies for eligibility. Our study analysis is planned in accordance with the guidelines for meta–analysis of diagnostic studies. In the systematic search, of 397 references, 295 were excluded on the basis of the title and abstract. For the remaining 102 articles, the full text was retrieved and critically reviewed. After the selection process, five papers were included.Results: The pooled estimate of all data showed that the RUSH protocol exhibited high sensitivity (0.87, 95% Confidence Interval (CI): 0.80-0.92, I2 = 46.7%) and specificity (0.98, 95% C. I.: 0.96-0.99, I2 = 30.8%). The AUC for SROC, a global measure of the RUSH protocol performance, was 0.98 ± 0.01, indicates the high accuracy of the test. Positive and negative likelihood ratios reported from the studies ranged from 9.83 to 51.32 and 0.04 to 0.33, respectively. The pooled estimate of all data showed that the RUSH protocol exhibited high positive likelihood ratio (19.19, 95% C. I.: 11.49-32.06, I2 = 14.1%) and low negative likelihood ratio (0.23, 95% C. I.: 0.15-0.34, I2 = 18.4%).Conclusion: This meta-analysis suggests that RUSH protocol has generally good role to distinguish the states of shock in patients with undifferentiated shock referred to the emergency department.
Thara Tunthanathip; Suphak Udomwitthayaphiban
Volume 7, Issue 4 , October 2019, , Pages 347-354
Abstract
Objective: To determine the factors associated with mortality in penetrating brain injury (PTBI) and proposed the nomogram predicting the risk of death. Methods: A retrospective cohort study was conducted on all patients who had sustained PTBI between 2009 and 2018. Collected data included clinical characteristics, ...
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Objective: To determine the factors associated with mortality in penetrating brain injury (PTBI) and proposed the nomogram predicting the risk of death. Methods: A retrospective cohort study was conducted on all patients who had sustained PTBI between 2009 and 2018. Collected data included clinical characteristics, neuroimaging findings, treatment, and outcomes. Prognostic factors analysis was conducted using a forest plot. Therefore, the nomogram was developed and validated. For the propose of evaluation, the nomogram’s sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), Receiver Operating Characteristic (ROC) curve and the area under the receiver operating characteristic (AUC) were determined for validating the optimal cut-off point of the total scores. Results: During the study period, 62 individuals enrolled. In the univariate analysis, factors associated with the morality were normal pupils’ reactivity to light (OR 0.04, p < 0.001), hypotension (OR 9.91, p <0.001), hypoxia (OR 10.2, p =0.04), bihemispheric injuries (OR 19.0, p =0.001), multilobar injuries (OR 21.5, p < 0.001), subarachnoid hemorrhage (OR 6.9, p = 0.02), intraventricular hemorrhage (OR 26.6, p = 0.006), basal cistern effacement (OR 28.8, , p <0.001), midline shift >5 mm (OR 0.19, p <0.001) were significantly associated with death. In multivariable analysis, hypotension (OR 8.82, p =0.03), normal pupils’ reactivity to light (OR 0.07, p =0.01), midline shift >5 mm (OR 18.23, p <0.007) were significantly associated with death. The nomogram’s sensitivity, specificity, PPV, NPV, and AUC for predicting mortality (total score ≥ 100) were 80%, 92.6%, 72.7%, 95.0%, and, 0.86 respectively. Conclusions: PTBI is the fatal injury depend on both clinical and neuroimaging parameters. The nomogram is the alternative method providing prognostic parameters toward implication for clinical decision making.
Ali Razmkon
Volume 1, Issue 1 , January 2013, , Pages 5-6
Sanjay Meena; Pankaj Kumar Sharma; Samarth Mittal; Jyoti Sharma; Buddhadev Chowdhury
Volume 5, Issue 1 , January 2017, , Pages 6-12
Abstract
Introduction: Modified Stoppa approach was introduced as an alternative to ilioinguinal approach for management of anterior fractures of acetabulum in order to reduce complications of the latter. However, the efficacy of either approach over other is not well established. The aim of this meta-analysis ...
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Introduction: Modified Stoppa approach was introduced as an alternative to ilioinguinal approach for management of anterior fractures of acetabulum in order to reduce complications of the latter. However, the efficacy of either approach over other is not well established. The aim of this meta-analysis is to compare the efficacy of modified stoppa and ilioinguinal approach in the management of acetabular fractures in terms of a) quality of reduction achieved b) complication rates c) functional outcomes d) operative time e) intra-operative blood loss.Methods: Databases of PubMed, EMBASE and Cochrane registry of controlled trials were taken into consideration for studies on modified Stoppa approach versus Ilioinguinal approach group for the treatment of anterior acetabular fractures. Dichotomous variables were presented as risk ratios (RRs) /Odds Ratio (OR) with 95% confidence intervals (CIs), and continuous data was measured as mean differences, with 95% CIs.Result: Four studies involving 375 patients were included in this meta-analysis. Out of those 375 patients, 192 were managed with ilioinguinal approach and 183 were managed with modified Stoppa approach. Anatomical reduction was significantly higher in Stoppa group (p=0.052, RR=1. 19 (1.02, 1.37), p=0. 90, I2=0%). The complication rate was significantly higher in the Ilioinguinal approach as compared with the Stoppa approach (p=0.01, RR 0.63 (0.44 to 0.91), p=0.73 (I2= 0%). The operative time was significantly shorter with modified Stoppa approach (MD = -48.79 (-80.29 to -17.30), p=0.002). No significant differences were found between the two groups in terms of their functional outcomes (p=0.63, RR 0.96 (-0.80 to 1.15), p=0. 56, I2=0%) and blood loss (MD= -212.89 (-476.27 to 50.49) p=0. 06, I2=71%).Conclusion: Anterior acetabular fractures, if operated with the modified Stoppa approach were found to have better reduction and lower complication rates with less operative time, when compared to ilioinguinal approach. No significant difference in terms of blood loss was found in both the groups. Further higher quality randomized controlled trials are needed to verify our results.
Darab Faraji; Mohsen Ebrahimi; Babak Paknezhad; Zahra Hami; Alireza Jahandideh
Volume 8, Issue 1 , January 2020, , Pages 10-18
Abstract
Objective: To assess regenerative capacities of chitosan-nanoselenium conduit on transected sciatic nerve in diabetic rats.Methods: A 10-mm sciatic nerve defect was bridged using a chitosan-nanoselenium conduit filled with phosphate buffered saline. In chitosan group, the chitosan conduit was ...
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Objective: To assess regenerative capacities of chitosan-nanoselenium conduit on transected sciatic nerve in diabetic rats.Methods: A 10-mm sciatic nerve defect was bridged using a chitosan-nanoselenium conduit filled with phosphate buffered saline. In chitosan group, the chitosan conduit was filled with phosphate buffered saline solution. In sham-operated group, sciatic nerve was exposed and closed. In transected group, right sciatic nerve was transected and nerve cut ends were fixed in the adjacent muscle. The regenerated fibers were studied within 12 weeks after surgery.Results: The behavioral and functional and electrophysiological tests confirmed faster recovery of the regenerated axons in chitosan-nanoselenium conduit group compared to chitosan group (p=0.001). The mean ratios of gastrocnemius muscles weight were measured. There was statistically significant difference between the muscle weight ratios of chitosan-nanoselenium conduit and chitosan groups (p=0.001). Morphometric indices of regenerated fibers showed number and diameter of the myelinated fibers were significantly higher in chitosan-nanoselenium conduit group than in chitosan group.Conclusion: chitosan-nanoselenium conduit resulted in acceleration of functional recovery and quantitative morphometric indices of sciatic nerve.
Nima Pourhabibi Zarandi; Parisa Javidi Parsijani; Shahram Bolandparvaz; Shahram Paydar
Volume 2, Issue 1 , January 2014, , Pages 15-21
Abstract
Objective: To evaluate the accuracy of surgeons’ intraoperative diagnosis in open appendectomy and compare it with the histopathology examination results afterwards.Methods: This was a cross-sectional retrospective study accomplished in Namazee hospital affiliated with Shiraz University of Medical ...
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Objective: To evaluate the accuracy of surgeons’ intraoperative diagnosis in open appendectomy and compare it with the histopathology examination results afterwards.Methods: This was a cross-sectional retrospective study accomplished in Namazee hospital affiliated with Shiraz University of Medical Sciences, in a one-year period from 2007 to 2008. Medical charts of all the patients who were admitted with impression of acute appendicitis and underwent open appendectomy in our center were included. Demographic information, intraoperative findings as in the operation note based on a method used by our surgeons, and histopathology examination of the removed appendix were recorded and reported.Results: A total of 342 patients were studied including 229 (67%) males and 113 (33%) females, with the mean age of 16.02 ± 9.89 (range 3 to 76) years, with a large proportion from 10 to 15 years. Surgeons reported 97.4% of the patients to have acute appendicitis,29.5%, 10.2% and 5.6% with severe, moderate and mild inflammation pectively, whereas 26.6% and 9.4% with suppurated and gangrenous appendicitis separately, 14.6% to have perforated appendicitis and only 1.5%hadperforated appendicitis with peritonitis. However, 79.5% of cases showed appendicitis in the histopathology review. The accuracy of surgeons’ intraoperative diagnosis is 81.6%, 85.2% for men and 72.6% for women.Conclusion: The method used by our surgeon is not completely indicative in mild to severe inflamed appendix but it is almost always compatible with the pathology results in suppurated, gangrened, and perforated appendix. Therefore surgeons’ gross observation of the inflamed appendix may not always be in concordance with the histopathology examination of the resected appendix.
Amirhosein Meisami
Volume 9, Issue 1 , January 2021, , Pages 15-20
Abstract
Objective: To determine the sensitivity, specificity and accuracy of ultrasound to diagnose the patients with tendon rupture of upper extremity referred to Taleghani Hospital’s center of Kermanshah in 2019. Methods: This was a diagnostic value study which performed on 113 patients with non-fracture ...
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Objective: To determine the sensitivity, specificity and accuracy of ultrasound to diagnose the patients with tendon rupture of upper extremity referred to Taleghani Hospital’s center of Kermanshah in 2019. Methods: This was a diagnostic value study which performed on 113 patients with non-fracture penetrating hand trauma. In the first stage, all patients have been diagnosed with tendon injury by a first-year resident and then ultrasound was performed by a trained 2nd year resident in emergency medicine ward and the results were recorded in a checklist. Further examination of the tendon was performed as well as exploring the site for the patients after the patient was transferred to the orthopaedic service. Final result was recorded in the checklist. Data were analysed by SPSS software and sensitivity and specificity of ultrasound have been calculated. Results: Results showed that ultrasound was able to identify 73 patients of 77 individuals with tendon injury. Of the patients with complete rupture, 45 individuals were correctly diagnosed based on the results of surgery in ultrasound test. Ultrasound and surgical findings were significantly different. Of the 36 individuals without confirmed rupture in surgery, 10 cases were diagnosed with tendon rupture by ultrasound. Of 52 cases of complete rupture based on surgical findings, 45 individuals were correctly diagnosed based on the results of surgery. Twenty-one patients were correctly diagnosed based on ultrasound out of 25 cases of partial rupture based on surgical findings. Conclusion: Overall, the results of the present study show that ultrasound is not very sensitive and specific in diagnosing of upper extremity tendon rupture and cannot be used as a reliable alternative in diagnosing of upper exteremity rupture; however, further studies is essential according to the limitations of this research. The limitations were low sample size in subgroups analysis based on the presence of complete or partial rupture and performing the ultrasound by an emergency medicine resident who is less experienced rather than radiologists.
Reza Eshraghi; Sina Shamsi; Masoumeh safaee
Volume 12, Issue 1 , January 2024, , Pages 15-20
Abstract
Objective: This study aimed to evaluate the outcome and risk factors in operative and non-operativemanagement of splenic injury.Methods: This cross-sectional study was conducted on patients with traumatic splenic injuries who werehospitalized in Kashani Hospital (Isfahan, Iran) from 2017 to 2019. The ...
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Objective: This study aimed to evaluate the outcome and risk factors in operative and non-operativemanagement of splenic injury.Methods: This cross-sectional study was conducted on patients with traumatic splenic injuries who werehospitalized in Kashani Hospital (Isfahan, Iran) from 2017 to 2019. The studied variables were extracted fromthe medical records of the enrolled participants. The outcomes such as mortality complications and risk factorswere compared based on treatment methods.Results: A total of 240 patients were investigated. The mean age of the patients was 29.8±12.2, with 180(77.5%) patients being men. 154 (64.2%) patients underwent operative treatment. The mortality rate was 18.9%and 4.6% among operative and non-operative groups (p<0.001). Complications were observed in 11.5% and46.1% of non-operative and operative groups, respectively (p<0.001). Operative treatment inversely correlatedwith mortality (p<0.001) and complications (p<0.05). Splenic injury severity was correlated positivelywith mortality (p<0.001) and negatively with complications (p<0.001). Unstable hemodynamic status waspositively correlated with complications (p<0.001). Age had a positive correlation with mortality (p<0.001)and complications (p<0.001). Male sex had a negative correlation with complications (p<0.001). GCS score andadmission were positively correlated with mortality (p<0.001). There was no statistically significant correlationbetween correlated injuries and outcomes (p≥0.05).Conclusion: Patients who received surgery had higher rates of mortality and complications. However, aftercontrolling for confounders, operative treatment was found to be inversely correlated with mortality andcomplications.
Ali Bazm; Elahe Khorasani; Manal Etemadi; Hadi Nadeali
Volume 3, Issue 1 , January 2015, , Pages 16-21
Abstract
Objectives: To develop a clear criteria for classifying the patients in triage unit of a tertiary healthcare center according to five-level triage system.Methods: This study is a qualitative study being conducted in five stages at Vali-Asr Hospital of Qom in 2013. After two survey, the experts were ...
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Objectives: To develop a clear criteria for classifying the patients in triage unit of a tertiary healthcare center according to five-level triage system.Methods: This study is a qualitative study being conducted in five stages at Vali-Asr Hospital of Qom in 2013. After two survey, the experts were interviewed using focus group discussion (FDG) and study was continue with. Data were analyzed through studying the opinions of the specialized teams' members, summarizing and classifying the data in qualitative phase.Results: Changes proposed in the triage form communicated by Iran's emergency department according to the participants' opinions include informing all the patients in the emergency department of some necessary information. Therefore, three parts of medical and medicinal history, vital signs and level of consciousness were added to the first part of the form and necessary emergency facilities were also added to the third level of triage.Conclusion: Measuring each item added to the general part of the triage form provides more precise diagnosis and more scientific classification, since the level to which the patient belongs should be identified based on medical history, clinical signs and level of consciousness.
Hassan Al-Thani; Gaby Jabbour; Ayman El-Menyar; Husham Abdelrahman; Ruben Peralta; Ahmad Zarour
Volume 6, Issue 1 , January 2018, , Pages 16-25
Abstract
Objective: To investigate the presentation, management and outcomes of left and right-sided traumatic diaphragmatic injury (TDI) in a single level I trauma center.Methods: This cross-sectional study was conducted during a 7-year period from 2008 to 2015 in a level I trauma center in Qatar. We included ...
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Objective: To investigate the presentation, management and outcomes of left and right-sided traumatic diaphragmatic injury (TDI) in a single level I trauma center.Methods: This cross-sectional study was conducted during a 7-year period from 2008 to 2015 in a level I trauma center in Qatar. We included all the patients who presented with TDIs during the study period. Data included demographics, mechanism of injury, associated injuries, initial vitals, emergency department disposition, length of ICU and hospital stay, ventilator days, management, and outcomes. The variables were analyzed and compared for patients with left (LTDI) and right (RTDI).Results: A total of 52 TDI cases (79% LTDI and 21% RTDI) were identified with a mean age of 31±11. LTDI patients were more likely to have higher Injury severity scores (p=0.50) and greater AAST organ injury scoring (p=0.661 for all) than RTDI patients. Surgical repair was performed for 85% LTDI vs. 73% RTDI (p=0.342). Recurrent DIs was reported only in LTDI (5.1% vs. 0.0%; p=0.911). Twelve patients died (9 LTDI and 3 RTDI), of them 5 had associated head injury.Conclusion: This single-institution study confirms that LTDI are more commonly diagnosed than RTDI. Exploratory laparotomy is the most frequent procedure considered for the management of diaphragmatic injuries in the emergency settings. To improve outcomes in patients presenting with TDI, large prospective multicenter studies are needed to standardize the TDI management protocols including the diagnostic workup, timing of surgical intervention, and the most appropriate approach of treatment.
Yousef Veisani; Amin Bakhtiyari; Fathola Mohamadian
Volume 10, Issue 1 , January 2022, , Pages 16-20
Abstract
Objective: To provide detailed of suicide and homicide mortality and calculate of years of life lost (YLLs) in Ilam province Iran, during 2014-2018. Methods: In this cross-sectional study, all deaths due to suicide and homicide were enrolled to estimate YLLs, in Ilam province between 2014-2018. ...
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Objective: To provide detailed of suicide and homicide mortality and calculate of years of life lost (YLLs) in Ilam province Iran, during 2014-2018. Methods: In this cross-sectional study, all deaths due to suicide and homicide were enrolled to estimate YLLs, in Ilam province between 2014-2018. The source of data was legal medicine organization (LMO). All analysis was performed at 0.05 significant levels using statistical software package STATA for Windows version 11.2 and SPSS 21 software. Results: The total YLLs of suicide and homicide were 15685 and 5317, respectively. 522 per 100,000 populations were suicide and 117 for homicide. The YLL and 95% confidence interval form suicide was 34.4 (32.8-36.1) for both sexes that 33.7 (31.6-35.8) for men, and 35.5 (32.7-38.3) for women. In this study period, YLLs rate began to increase over the years in both injury-related in 2016. Conclusion: Results of this study disclosed the most prominent contribution of men and peoples aged 15-29 to the YLLs. Also our results indicate a recent increase in suicide and homicide YLLs for both genders.
Ramin Ebrahimian; Zoubin Souri; Alireza Feizkhah; MohammadReza Mobayen; Habib Eslami; Mojdeh Esmailzadeh; Mohsen Ghorbani; Soroush Mirhedayati; Parissa Bagheri
Volume 11, Issue 1 , January 2023, , Pages 19-25
Abstract
Objective: To evaluate the spiral chest computed tomography (CT) scan findings in patients with multipletrauma during the COVID-19 pandemic.Methods: This retrospective study was performed on multiple trauma patients admitted to a tertiary hospital inthe north of Iran in 2020. All patients with multiple ...
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Objective: To evaluate the spiral chest computed tomography (CT) scan findings in patients with multipletrauma during the COVID-19 pandemic.Methods: This retrospective study was performed on multiple trauma patients admitted to a tertiary hospital inthe north of Iran in 2020. All patients with multiple trauma who had undergone a chest spiral CT were includedin this study. Furthermore, the data analysis was performed through descriptive and analytical statistics usingSPSS software.Results: A total of 600 patients were included over the study period. The mean age of patients was 48.2±20.3years. Of the total, 496 (65.3%) patients had blunt chest injuries, and 104 (34.7%) had penetrating chest injuries.Falling was the most common mechanical cause of chest trauma in 270 patients (45%). Surgical interventionswere performed in 110 (18.3%) patients. A total of 276 (46%) patients had chest injuries identified by CTscans. Many patients (15.6%) had ground-glass lung opacity in the CT scan reports. Lung consolidation,pneumothorax, lung contusion, hemothorax, and rib fractures were the most common.Conclusion: Due to the high frequency of typical findings in spiral CT scan examinations, obtaining a reliablehistory of trauma severity, injury mechanism, and a detailed physical examination is recommended beforeprescribing a CT scan for patients.
Saqer M Althunayyan
Volume 7, Issue 1 , January 2019, , Pages 21-27
Abstract
Endotracheal intubation is a lifesaving procedure that is performed in various settings within the hospital or even in the pre-hospital field. However, it can result in serious hemodynamic complications, such as post-intubation hypotension (PIH) and cardiac arrest. The most promising predictor of such ...
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Endotracheal intubation is a lifesaving procedure that is performed in various settings within the hospital or even in the pre-hospital field. However, it can result in serious hemodynamic complications, such as post-intubation hypotension (PIH) and cardiac arrest. The most promising predictor of such complications is the shock index (SI), which holds great prognostic value for multiple disorders. On the other hand, most of the studies that have assessed the predictability of the pre-intubation SI have been small and were limited to a particular setting of a single center; thus, the results were not generalizable, and the predictive value vary according to the setting. This review comprehensively assessed the utility of the pre-intubation SI for predicting PIH and post-intubation cardiac arrest by classifying and comparing evidence compiled from various settings, such as pre-hospital settings, emergency departments (EDs), intensive care units (ICUs), and operating rooms (ORs). The vast majority of these studies, conducted in ED and ICU settings, which revealed a significant correlation between an elevated SI and PIH or post-intubation cardiac arrest. The reliability and simplicity of obtaining a pre-intubation SI value are important considerations that encourage the extension of its use to all in-hospital intubations. Further studies are required to assess the predictive value of the SI in the pre-hospital setting.
Hosseinali Khalili; Aydin Omidvar; Fariborz Ghaffarpasand; Golnaz Yadollahikhales
Volume 4, Issue 1 , January 2016, , Pages 24-28
Abstract
Objective: To determine the effects of application of anti-adhesive films (OrthoWrap™) in traumatic decompressive craniectomy on prevention of adhesion formation and facilitation of subsequent cranioplasty.Methods: This was a retrospective cohort study being performed in Shahid Rajaei hospital (Shiraz ...
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Objective: To determine the effects of application of anti-adhesive films (OrthoWrap™) in traumatic decompressive craniectomy on prevention of adhesion formation and facilitation of subsequent cranioplasty.Methods: This was a retrospective cohort study being performed in Shahid Rajaei hospital (Shiraz Level I trauma center) during a 12-month period (from March 2012 to April 2013) including 93 patients undergoing traumatic decompressive craniectomy. Patients who received OrthoWrap™ during the initial craniectomy (n=44) were compared to those who did not (n=49). Two study groups were matched regarding the baseline characteristics. The perioperative indices including the surgical time, amount of bleeding, transfusion and 6-month Glasgow Outcome Scale (GOS) were compared between two study groups.Results: There was no significant difference between two study groups regarding the baseline characteristics. We found that the cranioplasty duration (113.3±33.2 vs. 146.9±34.9 minutes; p<0.001) and amount of intraoperative bleeding (182.1±98.3 vs. 270.6±77.6 mL; p=0.043) was significantly lower in those who had OrthoWrap™ compared to control group. The final GCS (p=0.052) as well as GOSE (p=0.653) was comparable between groups. The infection rate was comparable between two study groups (p=0.263).Conclusion: Application of OrthoWrap™ during decompressive craniectomy in those with severe traumatic brain injury is associated with shorter duration of operation and less intraoperative bleeding in subsequent cranioplasty. Infection rate and neurologic outcome was comparable between study groups.
