Hamid Kariman; Alireza Majidi; Sara Taheri; Ali Shahrami; Hamid Reza Hatamabadi
Volume 3, Issue 2 , April 2015, , Pages 46-52
Abstract
Objective: To compare the analgesiceffects of Nitrous oxide and morphine sulfate in patients with acute renalcolic due to urolithiasis.Methods: This was randomized clinical trial being performed in Imam Hossein hospital affiliated with Shahid Beheshti University of Medical Sciences during a 1-year ...
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Objective: To compare the analgesiceffects of Nitrous oxide and morphine sulfate in patients with acute renalcolic due to urolithiasis.Methods: This was randomized clinical trial being performed in Imam Hossein hospital affiliated with Shahid Beheshti University of Medical Sciences during a 1-year period from May2013 to May2014. A total of number of 100 patients, with an age range of 20-50 years, who presented with renal colic secondary to urolithiasis confirmed by ultrasonography were randomly assigned to receive morphine sulfate injection (0.1 mg/kg) with100 mg diclofenac suppository (n=50) or Entonox exhalation (50% nitric oxide and 50% oxygen)for 30-minutes with 100 mg diclofenac suppository (n=50). Quantitative measurement was of pain was performed according to a visual analogue scale (VAS), before, 3, 5, 10 and 30-minute after the intervention. The pain severity and side effects were measured between two study groups.Results: The baseline characteristics of the patients in two study groups were comparable. The frequencies of pain persistence (at least 50%) at 3-, 5-, 10- and 30-minute intervals in morphine sulfategroup were 96%, 80%,50% and 8%, respectively; these frequencies in Entonex were 82%, 42%, 12% and 2%, respectively (p<0.001). Cox regression modeling showed that use of Entonox was the only effective agent in the success of treatment, compared to the use of morphine, i.e. use of Entonox increased the success of treatment up to 2.1 folds compared to the use of morphine (HR=2.1; 95% CI: 1.2-3.6; p=0.006).Conclusion: The results of the present study demonstrate that inhalation of Entonox is an effective and safe analgesic regimen for acute renal colic. It acts more rapidly and is more potent in relieving renal colic when compared to morphine sulfate.Entonox can be regarded as an appropriate alternative to analgesics like opioids in this ground.Clinical Trial Registry: The current study is registered with Iranian Registry for Clinical Trials (www.irct.ir; IRCT2014120215620N4)
Hernando Alvis-Miranda; Sandra Milena Castellar-Leones; Luis Rafael Moscote-Salazar
Volume 1, Issue 2 , April 2013, , Pages 60-68
Abstract
Intracranial hypertension is the largest cause of death in young patients with severe traumatic brain injury. Decompressive craniectomy is part of the second level measures for the management of increased intracranial pressure refractory to medical management as moderate hypothermia and barbiturate coma. ...
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Intracranial hypertension is the largest cause of death in young patients with severe traumatic brain injury. Decompressive craniectomy is part of the second level measures for the management of increased intracranial pressure refractory to medical management as moderate hypothermia and barbiturate coma. The literature lack of concepts is their indications. We present a review on the state of the art.
Paria Bahrami; Ali Ardalan; Amir Nejati; Abbas Ostadtaghizadeh; Arezoo Yari
Volume 8, Issue 2 , April 2020, , Pages 62-76
Abstract
Objective: To examine all aspects affecting the functioning of the system and the most important factors in its assessment through a systematic review during 1990 to 2017. Methods: This systematic review of the current literature study was conducted during July 2017, and all articles, books, guidelines, ...
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Objective: To examine all aspects affecting the functioning of the system and the most important factors in its assessment through a systematic review during 1990 to 2017. Methods: This systematic review of the current literature study was conducted during July 2017, and all articles, books, guidelines, manuals and dissertations pertaining to the Incident Command System were analyzed. A total of articles and relevant documents were identified and finally these articles, which we found, were analyzed based on the specified indicators. Results: In this research 992 articles and relevant documents were identified and eventually, 48 articles were included and analyzed. The results were categorized into 6 main groups including 65 subgroups and 221 variables: features of hospital incident command system (14 subgroups and 53 variables), strengths of the system (15 subgroups and 70 variables), weaknesses of the system (10 subgroups and 15 variables), factors influencing the system's performance improvement (12 subgroups and 42 variables), factors that reduce the effectiveness of system include 11 subgroups (10 internal factors and 1 external factor) and 22 variables and important factors in assessing system performance (2 sub-groups and 19 variables). Conclusion: According to the results, Evaluating the effectiveness of a hospital accident command system (HICS) in a valid method can improve the efficiency of this system. In this appraisal, hospital managers and health decision-makers should consider principles, characteristics, strengths and weakness of it.
Hossein Zakeri; Lahya Afshari Saleh; Shabnam Niroumand; Maryam Ziadi-Lotfabadi
Volume 10, Issue 2 , April 2022, , Pages 65-70
Abstract
Objective: To compare the emergency severity index (ESI) and Manchester triage system (MTS) in trauma patients. Methods: This cross-sectional study was conducted by census method in Hasheminejad hospital during 2019. Patients referred to a trauma center triaged by five trained triage nurses based on ...
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Objective: To compare the emergency severity index (ESI) and Manchester triage system (MTS) in trauma patients. Methods: This cross-sectional study was conducted by census method in Hasheminejad hospital during 2019. Patients referred to a trauma center triaged by five trained triage nurses based on ESI and MTS. Outcomes were considered as length of stay at the emergency department, admission to the other sectors and discharge or leave the hospital. Information from the triage form, nursing registry office and hospital registry system were extracted and analyzed by SPSS software. Results: Totally 447 and 468 patients triaged with the ESI and MTS were included, respectively. Seventy percent of patients triaged with ESI and 34% with MTS were placed in level 3 or the yellow group (equivalent group 3 triage). The hospitalization rate is approximately equal at each triage level in the both systems. The mortality rate in both groups was 0%. Mean length of stay was significantly lower in the MTS group compared to ESI in the emergency department (p <0.05). Conclusion: Using of ESI triage in the trauma center causes to arrive more patients to the emergency department instead of the fast track and leads to waste the time and energy of staff’. However, further studies are needed to prove this result.
Mostafa Sadeghi; Peyman Saberian; Parisa Hasani-Sharamin; Fatemeh Dadashi; Sepideh Babaniamansour; Ehsan Aliniagerdroudbari
Volume 9, Issue 2 , April 2021, , Pages 67-72
Abstract
Objective: To assess the possible factors associated with increasing risk of COVID-19 among EMTs. Methods: This study was a case-control study conducted in Tehran, Iran. Case group was consisted of confirmed COVID-19 EMTs based on the results of reverse transcriptase polymerase chain reaction and/or lung ...
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Objective: To assess the possible factors associated with increasing risk of COVID-19 among EMTs. Methods: This study was a case-control study conducted in Tehran, Iran. Case group was consisted of confirmed COVID-19 EMTs based on the results of reverse transcriptase polymerase chain reaction and/or lung computed tomography scan. Healthy EMTs were randomly selected as control group. Patients were asked to fill out a checklist including demographic data, data related to the work situation (such as number of missions and type of mask and cloth) and PPE precautions. Results: Sixty-eight patients and 148 healthy persons took part in this study as case and control group, respectively. Having two EMTs involved directly in taking care of patients (p <0.001) and working with a confirmed case teammate (p <0.001), considering the precautions such as seal check after wearing the mask (p=0.015), covering the hair with a medical hat (p <0.001), not using personal items despite protective clothing (p <0.001), and avoiding contact with the outer surface of clothing while removing (p <0.001) had significant difference in two groups. Conclusion: We found that the type and method of use of PPE were correlated with the increasing risk of COVID-19 in EMTs. Also, we found that when two EMTs were involved directly in taking care of the patients, and those who worked with a confirmed case teammate, more frequently affected.
Nino Chkhaberidze; Ketevan Axobadze; Maia Kereselidze; Nato Pitskhelauri; Maka Jorbenadze; Nino Chikhladze
Volume 11, Issue 2 , April 2023, , Pages 75-82
Abstract
Objective: This study aimed to evaluate epidemiological aspects of fatal injuries in Georgia.Methods: This was a retrospective, descriptive study that included all traumatic injury deaths in Georgiafrom January 1 to December 31, 2018. The National Center for Disease Control and Public Health of Georgia’sThe ...
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Objective: This study aimed to evaluate epidemiological aspects of fatal injuries in Georgia.Methods: This was a retrospective, descriptive study that included all traumatic injury deaths in Georgiafrom January 1 to December 31, 2018. The National Center for Disease Control and Public Health of Georgia’sThe Electronic Death Register database was utilized in this research.Results: Of the study fatal injuries, 74% (n=1489) were males. 74% (n=1480) of all fatal injuries were causedby unintentional injuries. Road traffic accidents (25%, n=511) and falls (16%, n=322) were the primary causesof mortality. During the research year, the number of Years of life lost (YLL) was associated with injuries andwas increased to 58172 for both sexes (rate per 1000 population: 15.6). Most of the years were lost in the agegroup of 25-29 years (7515.37). Road traffic deaths accounted for 30% (17613.50) of YLL.Conclusion: Injuries are still a major public health problem in Georgia. In 2018, 2012 individuals died frominjuries across the country. However, mortality and YLL rates of injury varied by age and cause of injury. Toprevent injury-related mortality, it is crucial to conduct ongoing research on high-risk populations.
Alireza Baratloo; Farhad Rahmati; Alaleh Rouhipour; Maryam Motamedi; Elmira Gheytanchi; Fariba Amini; Saeed Safari
Volume 2, Issue 2 , April 2014, , Pages 77-81
Abstract
ABSTRACTObjective: To determine the correlation between blood gas parameters and central venous pressure (CVP) in patients suffering from septic shock.Methods: Forty adult patients with diagnosis of septic shock who were admitted to the ...
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ABSTRACTObjective: To determine the correlation between blood gas parameters and central venous pressure (CVP) in patients suffering from septic shock.Methods: Forty adult patients with diagnosis of septic shock who were admitted to the emergency department (ED) of Shohadaye Tajrish Hospital affiliated with Shahid Beheshti University of Medical Sciences, and met inclusion and exclusion criteria were enrolled. For all patients, sampling was done for venous blood gas analysis, serum sodium and chlorine levels. At the time of sampling; blood pressure, pulse rate and CVP were recorded. Correlation between blood gas parameters and hemodynamic indices were.Results: A significant direct correlation between CVP with anion gap (AG) and inversely with base deficit (BD) and bicarbonate. CVP also showed a relative correlation with pH, whereas it was not correlated with BD/AG ratio and serum chlorine level. There was no significant association between CVP and clinical parameters including shock index (SI) and mean arterial pressure (MAP).Conclusion: It seems that some of non invasive blood gas parameters could be served as alternative to invasive measures such as CVP in treatment planning of patients referred to an ED with septic shock.
Mahsa Dehghani; Nazila Moftian; Peyman Rezaei-hachesu; Taha Samad-soltani
Volume 5, Issue 2 , April 2017, , Pages 79-89
Abstract
Objective: To systematically review the current literature of simulation in healthcare including the structured steps in the emergency healthcare sector by proposing a framework for simulation in the emergency department.Methods: For the purpose of collecting the data, PubMed and ACM databases were used ...
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Objective: To systematically review the current literature of simulation in healthcare including the structured steps in the emergency healthcare sector by proposing a framework for simulation in the emergency department.Methods: For the purpose of collecting the data, PubMed and ACM databases were used between the years 2003 and 2013. The inclusion criteria were to select English-written articles available in full text with the closest objectives from among a total of 54 articles retrieved from the databases. Subsequently, 11 articles were selected for further analysis.Results: The studies focused on the reduction of waiting time and patient stay, optimization of resources allocation, creation of crisis and maximum demand scenarios, identification of overcrowding bottlenecks, investigation of the impact of other systems on the existing system, and improvement of the system operations and functions. Subsequently, 15 simulation steps were derived from the relevant studies after an expert’s evaluation.Conclusion: The 10-steps approach proposed on the basis of the selected studies provides simulation and planning specialists with a structured method for both analyzing problems and choosing best-case scenarios. Moreover, following this framework systematically enables the development of design processes as well as software implementation of simulation problems.
Ali Mehrshad; Ashkan Seddighnia; Mohammadreza Shadabi; Alireza Najafpour; Rahim Mohammadi
Volume 4, Issue 2 , April 2016, , Pages 80-87
Abstract
Objective: To assess the effect of heparin binding neurotrophic factor (HBNF) on sciatic nerve regeneration in animal model of rat.Methods: Seventy-five male Wistar rats were divided into five experimental groups randomly (each group containing 15 animals): Sham operation group (SHAM), autograft group ...
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Objective: To assess the effect of heparin binding neurotrophic factor (HBNF) on sciatic nerve regeneration in animal model of rat.Methods: Seventy-five male Wistar rats were divided into five experimental groups randomly (each group containing 15 animals): Sham operation group (SHAM), autograft group (AUTO), transected control (TC), chitosan conduit (CHIT) and heparin binding neurotrophic factor treated group (CHIT/HBNF). In AUTO group a segment of sciatic nerve was transected and reimplanted reversely. In SHAM group sciatic nerve was exposed and manipulated. In transected group left sciatic nerve was transected and stumps were fixed in adjacent muscle (TC). In treatment group defect was bridged using a chitosan conduit (CHIT) filled with 10 µL (0.1 mg/mL) HBNF (CHIT/HBNF). Each group was subdivided into four subgroups of five animals each and nerve fibers were studied in a 12-week period.Results: Behavioral, functional, biomechanical, electrophysiological and gastrocnemius muscle mass findings and morphometric indices confirmed faster recovery of regenerated axons in treatment group than in CHIT group (P=0.001). Immunohistochemical reactions to S-100 in treatment group were more positive than that in CHIT group.Conclusion: Local administration of HBNF improved functional recovery and morphometric indices of sciatic nerve. It could be considered as an effective treatment for peripheral nerve repair in practice.
Abbas Saroukhani; Hasan Ravari; Masoud Pezashki Rad
Volume 3, Issue 3 , July 2015, , Pages 86-92
Abstract
Objective: To evaluate the efficacy and safety of intravenous and catheter directed thrombolysis by recombinant tissue plasminogen activator (Alteplase) in the patients with non-traumatic acute limb ischemia (ALI).Methods: This was a randomized clinical trial being performed between 2009 and 2011 in ...
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Objective: To evaluate the efficacy and safety of intravenous and catheter directed thrombolysis by recombinant tissue plasminogen activator (Alteplase) in the patients with non-traumatic acute limb ischemia (ALI).Methods: This was a randomized clinical trial being performed between 2009 and 2011 in Mashhad University of Medical Sciences. We included those patients who were<75 years, with symptoms of less than 14 days duration, ALI of grade IIa and IIb (according to Rutherford classification) and absence of distal run off. Baseline assessment of peripheral circulation performed in all the patients. Patients were randomly assigned to undergo intravenous (n=18) or catheter directed thrombolysis (n=20) with Alteplase. The primary endpoint of the study was improvement of clinical status measured by Rutherford classification, ankle brachial index (ABI), visual analogue scale (VAS) score measured at 1, 3 and 6 months. The secondary endpoint of the study was complete or near complete recanalization of the occluded artery.Results: A total number of 38 patients with mean age of 54.13±13.5 years were included in the study. There were 23 (60.5%) men and 15 (39.5%) women among the patients. Overall 3 (7.9%) patients had upper and 35 (92.1%) lower extremity ischemia. There was no significant difference between two study groups. None of the patients experienced major therapeutic side effects. Both ABI and VAS score improved in patients who have received first dose of t-PA within 24-hourof ALI. There was no significant difference between two study groups regarding the 6-month clinical grade (p=0.088), VAS score (p=0.316) and ABI (p=0.360). The angiographic improvement was significantly higher in CDT group (p<0.001).Conclusion: Intravenous and catheter directed thrombolysis with t-PA is a safe and effective method in treatment of acute arteriolar ischemia of extremities. However there both intravenous thrombolysis and CDT are comparable regarding the clinical outcome.Clinical Trial Registry: The current study is registered with Iranian Registry for Clinical Trials (www.irct.ir; IRCT2014100719427N1)
Hassan Mashbari; Mohannad Hemdi; Kevin L. Chow; James C. Doherty; Gary J. Merlotti; Steven L. Salzman; Eduardo Smith Singares
Volume 6, Issue 2 , April 2018, , Pages 100-107
Abstract
Objective: To determine the optimal volume of abdominal irrigation that will prevent surgical site infections (both deep and superficial), eviscerations and fistula formations; and improve 30-day mortality in trauma patients.Methods: We conducted a three-arm parallel clinical superiority randomized controlled ...
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Objective: To determine the optimal volume of abdominal irrigation that will prevent surgical site infections (both deep and superficial), eviscerations and fistula formations; and improve 30-day mortality in trauma patients.Methods: We conducted a three-arm parallel clinical superiority randomized controlled trial comparing different volumes of effluent (5, 10 and 20 liters) used in trauma patients (both blunt and penetrating) age 14 and above undergoing an emergency laparotomy between April 2002 and July 2004 in a busy urban Level 1 trauma center.Results: After randomization, a total of 204 patients were analyzed. All patient groups were comparable with respect to age, gender distribution, admission injury severity score, and mechanism of injury, estimated blood loss and degree of contamination. The mortality rate overall was 1.96% (4/204).No differences were noted with respect to contamination, wound infection, fistula formation, and evisceration. The twenty liter group (Group III) showed a trend toward an increased incidence of deep surgical site infections when compared to the five liter (Group I) (p=0.051) and ten liter (Group II) (p=0.057) groups. This did not however reach statistical significance.Conclusion: The old surgical adage “the solution to pollution is dilution” is not applicable to trauma patients. Our results suggest that using more irrigation, even when large amounts of contamination have occurred, does not reduce post-operative complications or affect mortality; and it may predispose patients to increased incidence of abscess formation.(Trial registration number: ISRCTN66454589).
Sima Feizolahzadeh; Aliakbar Vaezi; Ali Taheriniya; Masoud Mirzaei; Mohammadreza Vafaeenasab; Davoud Khorasani-zavareh
Volume 7, Issue 2 , April 2019, , Pages 105-111
Abstract
Objective: Hospitals are expected to be able to provide quality services during disasters. However, hospital capacity is limited and most hospital beds are almost always occupied. The aim of this study was to determine the feasibility of increasing hospital surge capacity during disasters through identification ...
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Objective: Hospitals are expected to be able to provide quality services during disasters. However, hospital capacity is limited and most hospital beds are almost always occupied. The aim of this study was to determine the feasibility of increasing hospital surge capacity during disasters through identification of patients suitable for safe early discharge.Methods: This cross-sectional study was conducted from May 2017 to February 2018 in two phases. In phase I, the Early Discharge Checklist was developed by a multidisciplinary panel of experts. Then in phase II, the checklist was used to assess the dischargeability of 396 in-patients in general wards of hospitals in Alborz province, Iran. Data were analyzed through the SPSS software (v. 22.0) and the results were presented by descriptive and analytical statics at a significance level of less than 0.05.Results: Of 396 patients, (64.65%) were male, (68.9%) were married, and (38.6%) aged more than 54. Moreover, (34.6%) patients were dischargeable. Patients in cardiology wards were more dischargeable. At follow-up assessment, 33.3% of patients had been discharged after 48 hours. There was a significant relationship between patient dischargeability and 48-hour hospitalization status (p=0.001). Dischargeability had no significant relationships with patients’ demographic characteristics (p>0.05).Conclusion: A considerable percentage of in-patients are dischargeable during disasters. The Early Discharge Assessment Checklist, developed in this study, is an appropriate tool to provide reliable data about early dischargeability in disasters.
Farooq Ahmad Ganie; Ghulam Nabi Lone; Mushtaq Ahmed Chowdhary; Hafzulla lone
Volume 1, Issue 3 , July 2013, , Pages 108-111
Abstract
Objectives: The aim of this study was to evaluate the surgical approach in post traumatic diaphragmatic hernia.Methods: This prospective cross-sectional study was conducted in the Department of cardiovascular and thoracic surgery, Sher-i- Kashmir Institute of Medical Sciences (SKIMS), Kashmir, India. ...
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Objectives: The aim of this study was to evaluate the surgical approach in post traumatic diaphragmatic hernia.Methods: This prospective cross-sectional study was conducted in the Department of cardiovascular and thoracic surgery, Sher-i- Kashmir Institute of Medical Sciences (SKIMS), Kashmir, India. We included all patients with post traumatic diaphragmatic hernia undergoing operation in our center from May 2009 to November 2011. A detailed history was taken for each patient along with comprehensive general, physical, systemic and local examination of all cases. Operative findings included associated intra-abdominal injuries, and herniated intra-abdominal organs. Post-operative complications, mortality and survival were recorded and reported.Results: The mean age of the patients was 32±1 years and there were 16 (76.1%) men and 5 (23.8%) women among the patients. Thoracotomy was performed in 14 patients (66.7%), laparotomy in 6 patients (28.6%) and combined procedure was used in 1 patient (4.7%). The reduction of hernia contents with repair of diaphragmatic rent was done in 11 (52.2%) of the patients and splenectomy with repair of rent in 6 (28.6%). Traumatic diaphragmatic hernia had 81.8% survival rate, no pre-operative mortality and 14.3% post operative mortality rate.Conclusion: Thoracotomy is the most common approach in post traumatic diaphragmatic hernia. Laparotomy is preferred in patients having acute trauma with associated intra-abdominal injuries.
Arash Mani; Rohallah Rostami; Ali Alavi Shoushtari; Shahram Paydar
Volume 2, Issue 3 , July 2014, , Pages 110-114
Abstract
Objectives: To describe the executive function of patients with traumatic injury admitted to Rajaei hospital, Shiraz, Iran and to compare the executive function between normal individuals and those with Attention Deficit Hyperactivity Disorder (ADHD).Methods: This was a case control study being performed ...
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Objectives: To describe the executive function of patients with traumatic injury admitted to Rajaei hospital, Shiraz, Iran and to compare the executive function between normal individuals and those with Attention Deficit Hyperactivity Disorder (ADHD).Methods: This was a case control study being performed during a 6-month period during spring and summer of 2013 in Shiraz level I trauma center. We included all patients admitted during the study period with impression of traumatic injury with or without adult ADHD. The patients’ demographic factors were assessed throughself-report questionnaire and executive functions by Wisconsin Card Sort Test (WCST) and Tower of London (TOL) Results were compared between normal individuals and those with ADHD.Results: Among 60 patients evaluated during the study period, with impression of traumatic injury, 29 fulfilled adult ADHD criteria and 31 were normal. The mean age of ADHD patients was 27.16±5.6 years and that of normal individuals was 26±3.4 years (p=0.330). There were no significant differences between two study groups regarding IQ (p=0.191) and education (p=0.396). Patients with ADHD had significantly poorer mean in executive functions in different parts of the test scoring system when compared to normal individuals.Conclusion: ADHD patients with traumatic injury had poor executive function compared to normal individuals. This might lead to poor inhibition, shifting and problem solving in this population.
Mahnaz Yadollahi; Mehrdad Karajizadeh; Najmeh Bordbar; Zahra Ghahramani; Leila Shayan
Volume 10, Issue 3 , July 2022, , Pages 110-115
Abstract
Objective: To evaluate the effect of COVID-19 pandemic on the incidence and mortality rate of road trafficinjuries in Shiraz, Iran.Methods: This cross-sectional study was performed on the data of patients who admitted by road trafficaccidents 18 months before the outbreak of COVID-19 and 18 months after ...
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Objective: To evaluate the effect of COVID-19 pandemic on the incidence and mortality rate of road trafficinjuries in Shiraz, Iran.Methods: This cross-sectional study was performed on the data of patients who admitted by road trafficaccidents 18 months before the outbreak of COVID-19 and 18 months after COVID-19 in the largest providerof trauma level 1 care services in southern Iran. SPSS 19 software was used to analyze the data.Results: A significant decrease of 12.8% was observed in the number of patients admitted by road trafficaccidents during the COVID-19 pandemic period compared to the same period before the pandemic (p<0.0001).But the death toll from road traffic accidents has increased significantly during the COVID-19 pandemic periodcompared to the same period before the pandemic (p=0.01).Conclusion: Due to the COVID-19 restrictions, it seems that factors such as restrictions on suburban travel,closure of public and recreational spaces, reduction of intra-city traffic, people staying at home and a significantreduction in injuries caused by traffic accidents, is reasonable. On the other hand, these restrictions, quarantines,and COVID disease itself can lead to confusion, anxiety, fear of infection, and thus avoid or delay the searchfor health care and increase mortality. Therefore, planning and policy-making is essential in order to preparethe correct guidance for seeking treatment.
Mohammad Babaei; Gholamreza Najafi; Ali Shalizar Jalali; Mehdi Behfar
Volume 3, Issue 4 , October 2015, , Pages 122-127
Abstract
Objective: To determine bilateral effects of unilateral iatrogenic vas deferens trauma (UIT) on epididymal sperm characteristics and in vitro fertilizing capacity in an experimental mouse model.Methods: Experiments were performed on three equal groups each comprising six adult male mice. Following anaesthesia, ...
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Objective: To determine bilateral effects of unilateral iatrogenic vas deferens trauma (UIT) on epididymal sperm characteristics and in vitro fertilizing capacity in an experimental mouse model.Methods: Experiments were performed on three equal groups each comprising six adult male mice. Following anaesthesia, UIT was induced by clamping left vas deferens with a mosquito clamp in fully locked fashion for 2 minutes in UIT group. Control-sham mice only had exposure of the left vas deferens through a groin incision. Control animals only received ceftriaxone (100 mg/kg) intraperitoneally at the day of experimental UIT induction. Ipsilateral and contralateral epididymal sperm characteristics and in vitro fertilizing capacity were evaluated after 35 days.Results: UIT significantly decreased sperm concentration, motility and viability as well as fertilization, two-cell embryos, blastocysts and hatched blastocysts rates. Moreover, incidence of DNA damage and abnormality in spermatozoa was significantly higher in UIT group.Conclusion: The findings suggest that a non-recognized iatrogenic vas deferens trauma may have detrimental effects on spermatozoa leading to infertility.
Mohammad Javad Moradian; Ali Ardalan; Amir Nejati; Ali Darvishi Boloorani; Ali Akbarisari; Behnaz Rastegarfar
Volume 4, Issue 3 , July 2016, , Pages 124-125
Sophia Aguirre; Kristen M. Jogerst; Zachary Ginsberg; Sandeep Voleti; Puneet Bhullar; Joshua Spegman; Taylor Viggiano; Jessica Monas; Douglas Rappaport
Volume 9, Issue 3 , July 2021, , Pages 125-132
Abstract
Objective: To investigate in how the current COVID-19 pandemic affects patient’s perceptions of emergency physician empathy and communication. Methods: Patients cared for by Emergency Department physicians with the lowest satisfaction scores were surveyed within one week of discharge via phone. ...
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Objective: To investigate in how the current COVID-19 pandemic affects patient’s perceptions of emergency physician empathy and communication. Methods: Patients cared for by Emergency Department physicians with the lowest satisfaction scores were surveyed within one week of discharge via phone. Using questions from the Consultation and Relational Empathy (CARE) survey, patients rated their satisfaction with their Emergency provider’s empathy and communication on a scale of 1 to 5 and provided feedback on how the patient-provider interaction could be improved. Demographic data and patient responses to CARE survey questions were compared between preCOVID-19 and during COVID-19 time. Patient’s open-ended responses were analyzed for themes related to the impact of COVID-19 on the patient-provider relationship. Results: Patient median quantitative scores were 5 (4-5) across all five questions of pre-COVID-19 and 5 (4-5) during COVID-19 for all questions except two (showing care and compassion), median 5(5-5). Female patients rated provider empathy and communication lower than mens. There was no differences across age strata. A shift in provider focuses to COVID-19 only care (N=3), and an understanding of the stress on healthcare processes (N=13) from open-ended responses themes emerged of patients who want to minimize interactions within the emergency department (N=3). Conclusion: The external factor of the current pandemic did not negatively impact patient’s satisfaction scores. Many patients express leniency and gratitude for emergency providers during this challenging time. Their responses seem to mirror current societal views of frontline healthcare workers.
Zahra Ghahramani; Anahita Mehrpour; Leila Shayan
Volume 1, Issue 4 , October 2013, , Pages 139-140
Jose Ramon Auso-Perez; Gloria Maria Rodríguez-Blanes
Volume 8, Issue 3 , July 2020, , Pages 142-147
Abstract
Objective: To describe the demographic characteristics and to assess possible risk factors related to the moment of presentation at Emergency Department (ED) for pediatric humeral supracondylar fractures. Methods: This was cross-sectional study being conducted during 5-year period from 2013 to 2017 at ...
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Objective: To describe the demographic characteristics and to assess possible risk factors related to the moment of presentation at Emergency Department (ED) for pediatric humeral supracondylar fractures. Methods: This was cross-sectional study being conducted during 5-year period from 2013 to 2017 at ED of a regional hospital in Spain. We have included all the pediatric patients ( Results: We have included 52 pediatric patients with supracondylar fractures in this series. The mean age was 7.48 ± 2.97 years with a minimum age of 2 years and a maximum of 14 years. Among the patients there were 32 (61.54%) male and 20 (38.46%) female. Age less than 7 years found to be a protective factor against unstable fractures [OR 0.33 (0.10 - 1.02)]. Fractures presented during daytime hours showed a greater instability [OR 3.49 (1.07-11.39)]. However, the risk of presentation at nighttime was higher during the summer months (June to September). Conclusion: The older is the child, the greater is the risk of suffering an unstable fracture, which increases the need for surgery. This risk is greater during the daytime. Otherwise, during the summer months, there is a higher risk of patient presentation at nighttime.
Seyed Reza Modarres; Mohammad Hossein Shokrollahi; Mohsen Yaserian; Maryam Rahimi; Neda Amani; Ali Asghar Manouchehri
Volume 2, Issue 4 , October 2014, , Pages 146-150
Abstract
Objective: To determine the epidemiological characteristics of fatal traumatic accidents in patients referred to a hospital in Babol, Northern Iran.Methods: Thiswas a cross-sectionalstudy being performed during a 1-year period including all the dead trauma patients referred to ShahidBeheshtiHospital ...
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Objective: To determine the epidemiological characteristics of fatal traumatic accidents in patients referred to a hospital in Babol, Northern Iran.Methods: Thiswas a cross-sectionalstudy being performed during a 1-year period including all the dead trauma patients referred to ShahidBeheshtiHospital of Babol. We included all those patients who were transferred to our center to trauma and injuries and passed away during the hospital stay. Those who dieddue toelectrical shock, drowningandsuffocationcaused byhangingsandpoisoningwereexcluded from the study.Demographic information such as age, sex, marital status, education, employment, the type, location, and time of injury, injured parts of body and treatment methods, the cause, location and time of death were recorded.Results: From the 92 dead patients, 76were men(82.6%) and16were women (17.4%). The cause of deathin 53 cases (57.6%) washead injury. Regarding the location,30patients (32.6%) diedat thesceneof the accident,62(67.4%) diedin the hospital. The maximum rateof trauma occurredin the afternoon shiftbetween the hours of13:30 to 19:30.The headand facewere themost damaged organs.Road traffic accidents were the most common cause of injury related mortality recordedin 81 patients (88.0%). Most of the accidentsoccurredinintercity roads in 27 people (33.3%) and the others inrural-urbanroads. Pedestrianswere the most common victims of road traffic accidents mortality being reported in 29 people (35.8%).Conclusion: Road traffic accidents are among the most common cause of injury related mortality in our region. Increasing the public knowledge and improve the traffic law enforcement measures should be considered for decreasing the morbidity and mortality.
Amir Amniattalab; Rahim Mohammadi
Volume 5, Issue 3 , July 2017, , Pages 152-159
Abstract
Objectives: To study the functional, histopathological and immunohistochemical effect of cyclosporine A on sciatic nerve regeneration using allografts in a rat sciatic nerve model.Methods: Thirty male white Wistar rats were divided into three experimental groups (n = 10), randomly: Normal control group ...
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Objectives: To study the functional, histopathological and immunohistochemical effect of cyclosporine A on sciatic nerve regeneration using allografts in a rat sciatic nerve model.Methods: Thirty male white Wistar rats were divided into three experimental groups (n = 10), randomly: Normal control group (NC), allograft group (ALLO), CsA treated group (ALLO/ CsA). In NC group left sciatic nerve was exposed through a gluteal muscle incision and after homeostasis muscle was sutured. In the ALLO group the left sciatic nerve was exposed through a gluteal muscle incision and transected proximal to the tibio-peroneal bifurcation where a 10 mm segment was excised. The same procedure was performed in the ALLO/ CsA group and the animals were treated with interaperitoneal administration of cyclosporine A. The harvested nerves of the rats of ALLO group were served as allograft for ALLO/ CsA group and vice versa. The NC and ALLO groups received 300 μL sterile olive oil interaperitoneally once a day for one week and the ALLO/ CsA group received 300 μL CsA (1mg/kg/day) interaperitoneally once a day for one week.Results: Behavioral, functional, biomechanical and gastrocnemius muscle mass showed earlier regeneration of axons in ALLO/ CsA than in ALLO group (p=0.001). Histomorphometic and immunohistochemical studies also showed earlier regeneration of axons in ALLO/ CsA than in ALLO group (p=0.034).Conclusion: Administration of CsA could accelerate functional recovery after nerve allografting in sciatic nerve. It may have clinical implications for the surgical management of patients after nerve transection in emergency conditions.
Soheil Rafiee; Alireza Baratloo; Arash Safaie; Alireza Jalali; Khalil Komlakh
Volume 10, Issue 4 , October 2022, , Pages 165-171
Abstract
Objective: To probe the factors associated with the outcomes of traumatic brain injury (TBI) patients admittedto emergency department (ED).Methods: This is a cross-sectional study that data gathering was performed via census methods, retrospectively.During one year, all head injury’s patients who ...
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Objective: To probe the factors associated with the outcomes of traumatic brain injury (TBI) patients admittedto emergency department (ED).Methods: This is a cross-sectional study that data gathering was performed via census methods, retrospectively.During one year, all head injury’s patients who admitted to the ED of a tertiary center in Tehran, Iran wereincluded. Age, gender, mechanism of injury, Glasgow coma scale (GCS) and injury severity score (ISS)on admission, presence of extra-cranial injuries, findings of brain computed tomography (CT), duration ofhospitalization, and in hospital outcomes were recorded. Outcome’s assessment for survivors was performedwithin a 6 months-period after discharge based on Glasgow outcome scale (GOS). The variables and outcomes’association were assessed.Results: Totally, 506 patients were evaluated with the mean age of 36.77±21.1 years that 411 (81.2%) were men.Follow up at 6-months post injury was feasible in 487 (96.2%) patients; 59 (11.7%) out of 506 eligible patientsdied. Logistic regression analysis showed the association between assessed variables and patients’ outcome asfollows: age>65 years (OR: 12.21; p<0.001), GCS on admission <8 (OR: 62.99; p<0.001), presence of traumaticIntracerebral hemorrhage (ICH) in brain CT scan (OR: 20.11; p=0.010), duration of hospitalization ≥ 5 days(OR: 0.28; p=0.001).Conclusion: The findings of the current study distinguished some variables that were associated with thepoor outcome of the patients with TBI. Therefore, TBI patients with any of these risk factors may need closecontinues monitoring, early ICU admission, and some other special extra care in ED.
Hamid Rezaei; Ehsan Keykhosravi; Amin Tavallaii
Volume 9, Issue 4 , October 2021, , Pages 178-182
Abstract
Objective: To evaluate the characteristics and in-hospital outcomes of traumatic spinal injuries among children admitted to a local trauma center in Iran. Methods: Patients aged 0-18 years who had been admitted to Shahid Kamyab trauma center for acute traumatic spinal injury (Mashhad, Iran) between 2011 ...
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Objective: To evaluate the characteristics and in-hospital outcomes of traumatic spinal injuries among children admitted to a local trauma center in Iran. Methods: Patients aged 0-18 years who had been admitted to Shahid Kamyab trauma center for acute traumatic spinal injury (Mashhad, Iran) between 2011 and 2018 were evaluated retrospectively. Various demographic, clinical, radiological, and outcome variables were recorded and analyzed. Results: A total of 127,300 trauma patients were evaluated and amongst them, 61 children had spinal trauma. The mean age was 11.1 and there was no significant sex preponderance (54% males). Most of the injuries were occurred in summer (34.4%) and the most common trauma mechanism was motor vehicle accidents (55.7%) followed by falling (36.1%). Almost all patients (95.1%) had vertebral fractures, which were in the cervical, thoracic, and lumbosacral area in order to decrease incidence. 67.2% of patients were managed non-surgically. The mean hospital stay was 8.9 days and 82.0% of patients had been discharged with normal motor function. Conclusion: Pediatric spinal trauma is less studied entity in the field of traumatology due to the lower prevalence of these injuries in pediatric patients worldwide. But our study shows a higher prevalence of such injuries in the pediatric population. Although controversial, the leading cause of these injuries is motor vehicle accidents. Fortunately, short term in-hospital outcome seems to be good in such injuries.
Seyed Mohammad Hosseini Kasnavieh; Kehan Koukli; Mohamad Veisi; Mohammad Amerzadeh; Hossein Hosseinifar; Ali Tahmasebi
Volume 11, Issue 4 , October 2023, , Pages 178-183
Abstract
Objective: This study aimed to investigate the necessity of cervical collars in patients with neck problems.Methods: This cross-sectional study was conducted on 114 patients who were admitted to the Haft Tir andRasoul Akram Hospitals (Tehran, Iran) from August to September 2022. The Nexus protocol was ...
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Objective: This study aimed to investigate the necessity of cervical collars in patients with neck problems.Methods: This cross-sectional study was conducted on 114 patients who were admitted to the Haft Tir andRasoul Akram Hospitals (Tehran, Iran) from August to September 2022. The Nexus protocol was used to selectthe patients with cervical collars. According to the protocol, a cervical collar was required for individuals whohad at least one symptom. If none of these symptoms existed, the cervical collar was deemed unnecessary. Thedata were analyzed using the Chi-square test and Fisher’s exact test.Results: Of the 114 trauma patients, the cervical collar was used unnecessarily by 49 (43%) patients. Tendernesswas the most common complication in 62 patients (54.4%). The prevalence of unnecessary cervical collaruse was 37.5% in female trauma patients and 43.88% in male trauma patients, which was not statisticallysignificant (p=0.63). The prevalence of unnecessary cervical collar use in trauma patients with multiple traumawas 39.42% and 80% in patients without multiple trauma, which was statistically significant (p=0.018). Patientswith a medical history had a higher rate of unnecessary use of the cervical collar (47.96%) than those withouta history (12.5%), and this difference was statistically significant (p=0.008).Conclusion: The guidelines for using cervical collars need to be updated by the EMS. Due to the large numberof trauma patients in Iran, cervical collars for necessary conditions can help reduce healthcare expensesand injuries caused by unnecessary cervical collars.
