Mehdi Torabi; Zahra-Sadat Amiri; Moghaddameh Mirzaee
Volume 11, Issue 2 , April 2023, , Pages 83-89
Abstract
Objective: This study aimed to investigate blood glucose levels in patients with brain injury caused by mildtraumatic brain injury (TBI) as a foundation for determining whether these patients need a brain CT scan ornot.Methods: This cross-sectional study was conducted on patients with mild TBI, who were ...
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Objective: This study aimed to investigate blood glucose levels in patients with brain injury caused by mildtraumatic brain injury (TBI) as a foundation for determining whether these patients need a brain CT scan ornot.Methods: This cross-sectional study was conducted on patients with mild TBI, who were referred to theemergency department from March 1, 2022, to September 1, 2022. After the confirmation of mild TBI by anemergency medicine specialist, blood samples were taken from the patients to measure blood glucose levels.Then a brain CT scan was performed, and blood glucose levels were compared between patients with andwithout CT indications of brain injury. A checklist was used to collect data, and the data were analyzed usingSPSS software (version 23).Results: In the CT scans of the 157 patients included in the study, 30 patients (19.2%) had a brain injury inthe CT scan. The mean blood glucose level was significantly higher in patients with brain injury, especially inthe presence of vertigo and ataxia, than patients without brain injury in the CT scan (p<0.0001). There was asignificant positive correlation between age and blood glucose level (r=0.315, p<0.0001).Conclusion: Patients with mild TBI who had signs of brain injury in the CT scan had significantly higher bloodglucose levels than patients with normal CT scan findings. Although indications for performing a brain CTscan are usually based on clinical criteria, blood glucose levels can be helpful in determining the requirementfor a brain CT scan in patients with mild TBI.
Behnaz Poorian; Mehdi Bemanali; Mohammad Chavoshinejad
Volume 4, Issue 2 , April 2016, , Pages 88-92
Abstract
Objective: To evaluate sensorimotor nerve damage in patients with maxillofacial trauma referring to Taleghani hospital, Tehran, IranMethods: This cross-sectional study was conducted during a 2-year period from 2014 to 2012 in Taleghani hospital of Tehran. We included a total number of 495 patients with ...
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Objective: To evaluate sensorimotor nerve damage in patients with maxillofacial trauma referring to Taleghani hospital, Tehran, IranMethods: This cross-sectional study was conducted during a 2-year period from 2014 to 2012 in Taleghani hospital of Tehran. We included a total number of 495 patients with maxillofacial trauma referring to our center during the study period. The demographic information, type of fracture, location of fracture and nerve injuries were assessed and recorded in each patients. The frequency of sensorimotor injuries in these patients was recorded. Data are presented as frequencies and proportions as appropriate.Results: Overall we included 495 patients with maxillofacial trauma with mean age of 31.5±13.8 years. There were 430 (86.9% men and in 65 (13.1%) women among the patients. The frequency of nerve injuries was 67.7% (336 patients). The mean age of the patients with nerve injuries was 33.4 ± 3.7 years. Marginal mandibular branch of facial nerve was the most common involved nerve being involved in 5 patients (1%). Regarding trigeminal nerve, the inferior alveolar branch (194 patients 39.1%) was the most common involved branch followed by infraorbital branch (135 patients 27.2%). Mandibular fracture was the most common injured bone being reported in 376 patient (75.9%) patients followed by zygomatic bone in 100 patient (20%).Conclusion: The most frequent fracture occurred in mandible followed by zygoma and the most injured nerve was inferior alveolar nerve followed by infraorbital branch of trigeminal nerve. In facial nerve the marginal branch was the most involved nerve. The frequency of nerve injury and the male to female ratio was higher in the current study compared to the literature.
Elahe Parva; Reza Boostani; Zahra Ghahramani; Shahram Paydar
Volume 5, Issue 2 , April 2017, , Pages 90-95
Abstract
Clinical databases can be categorized as big data, include large quantities of information about patients and their medical conditions. Analyzing the quantitative and qualitative clinical data in addition with discovering relationships among huge number of samples using data mining techniques could unveil ...
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Clinical databases can be categorized as big data, include large quantities of information about patients and their medical conditions. Analyzing the quantitative and qualitative clinical data in addition with discovering relationships among huge number of samples using data mining techniques could unveil hidden medical knowledge in terms of correlation and association of apparently independent variables. The aim of this research is using predictive algorithm for prediction of trauma patients on admission to hospital to be able to predict the necessary treatment for patients and provided the necessary measures for the trauma patients who are before entering the critical situation. This study provides a review on data mining in clinical medicine. The relevant, recently-published studies of data mining on medical data with a focus on emergency medicine were investigated to tackle pros and cons of such approaches. The results of this study can be used in prediction of trauma patient’s status at six hours after admission to hospital.
Arash Mani; Seyed Ali Dastgheib; Atie Chanoor; Hosseinali Khalili; Laaya Ahmadzadeh; Jamshid Ahmadi
Volume 3, Issue 3 , July 2015, , Pages 93-96
Abstract
Objective: To evaluate and describe the sleep quality in seven subscales among the patients with mild traumatic brain injury (TBI) and compare it with normal patterns.Methods: This cross-sectional study was conducted within a 6-month period from February to August 2014 in Shahid Rajaei trauma center ...
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Objective: To evaluate and describe the sleep quality in seven subscales among the patients with mild traumatic brain injury (TBI) and compare it with normal patterns.Methods: This cross-sectional study was conducted within a 6-month period from February to August 2014 in Shahid Rajaei trauma center of Shiraz. Participants were selected randomly from all adult (18-60 years of age) patients admitted during the study period with impression of mild TBI (GCS of more than 13). The patients’ sleep quality and demographic characteristics were evaluated by Pittsburgh sleep quality index (PSQI) and self-report questionnaire, respectively. Results were compared with normal data, which extracted from the normative data of PSQI manual.Results: Overall we included 60 patients with mild TBI with mean age of 36.2 ± 13.4 years. All the patients had sleep disturbance. Among them there were 46 (76.7%) men and 14 (23.3%) women. The subjective sleep quality (p=0.01), sleep latency (p=0.01), habitual sleep efficiency (p=0.01), sleep disturbance (p=0.01), use of sleep medication (p=0.01) and day time dysfunction (p=0.01) were significantly lower in patients with mild TBI when compared to those with mild TBI when compared to normal values. There were no difference between men and women regarding the sleep quality. The sleep duration was comparable between the subjects and the normal values.Conclusion: Patients with mild TBI have poor sleep quality which should be considered as one of the main factors in interventions after the injury and it might lead to better quality of life.
Rahim Mohammadi; Dana Anousheh; Mohammad-Hazhir Alaei; Amin Nikpasand; Hawdam Rostami; Rasoul Shahrooz
Volume 6, Issue 2 , April 2018, , Pages 108-114
Abstract
Objective: To determine the effects of bone marrow derived mast cells (BMMCs) on functional recovery of transected sciatic nerve in animal model of cat.Method: A 20-mm sciatic nerve defect was bridged using a silicone nerve guide filled with BMMCs in BMMC group. In Sham-surgery group (SHAM), the sciatic ...
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Objective: To determine the effects of bone marrow derived mast cells (BMMCs) on functional recovery of transected sciatic nerve in animal model of cat.Method: A 20-mm sciatic nerve defect was bridged using a silicone nerve guide filled with BMMCs in BMMC group. In Sham-surgery group (SHAM), the sciatic nerve was only exposed and manipulated. In control group (SILOCONE) the gap was repaired with a silicone nerve guide and both ends were sealed using sterile Vaseline to avoid leakage and the nerve guide was filled with 100 μL of phosphate-buffered saline alone. In cell treated group ([SILOCONE/BMMC) the nerve guide was filled with 100 μL BMMCs (2× 106 cells/100 μL). The regenerated nerve fibers were studied, biomechanically, histologically and immunohiscochemically 6 months later.Results: Biomechanical studies confirmed faster recovery of regenerated axons in BMMCs transplanted animals compared to control group (p<0.05). Morphometric indices of the regenerated fibers showed that the number and diameter of the myelinated fibers were significantly higher in BMMCs transplanted animals than in control group (p<0.05). In immunohistochemistry, location of reactions to S-100 in BMMCs transplanted animals was clearly more positive than that in control group.Conclusion: BMMCs xenotransplantation could be considered as a readily accessible source of cells that could improve recovery of transected sciatic nerve.
Bijan Ziaeian; Sedigheh Tahmasebi; Hadi Niakan; Afsoun Fazelzadeh
Volume 1, Issue 3 , July 2013, , Pages 112-115
Abstract
Objectives: To compare the results of early versus late tracheostomy in trauma patients admitted to intensive care unit (ICU).Methods: This was case control study being performed at a major trauma centre in Shiraz, Iran including 120 trauma patients admitted to ICU during a 2-year period and underwent ...
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Objectives: To compare the results of early versus late tracheostomy in trauma patients admitted to intensive care unit (ICU).Methods: This was case control study being performed at a major trauma centre in Shiraz, Iran including 120 trauma patients admitted to ICU during a 2-year period and underwent tracheostomy during their ICU stay. The patients were categorized into two groups of the early tracheostomy who underwent tracheostomy within the first 7 days of initiation of mechanical ventilation (n=60), and the late tracheostomy group, in which tracheostomy was performed after 7 days (n=60). The duration of mechanical ventilation, ICU stay and hospital stay as well as mortality rates in ICU and hospital were recorded and compared between two study groups.Results: The baseline characteristics such as age (p=0.325), sex (p=0.071), Glasgow coma scale (GCS) (p=0.431) and the mechanism of injury (p=0.822) were comparable between two study groups. Early tracheostomy was associated with a significantly shorter duration of mechanical ventilation (p=0.008) and shorter ICU stay (p=0.003). Hospital stay (p=0.165), ICU mortality (p=0.243), and hospital mortality (p=0.311) were not different between the two study groups.Conclusion: Early tracheostomy is associated with reduced ICU stay and shorter duration of mechanical ventilation. Adopting a standardized strategy may improve resource utilization.
Mohamad Javad Moradian; Zahra Mehraein Nazdik
Volume 7, Issue 2 , April 2019, , Pages 112-117
Abstract
Objective: To compare the effect of lecture and game methods in disaster risk education on high school students' knowledge.Methods: This research was a randomized field trial of educational intervention for high school’s students in Shiraz, Iran. Through cluster sampling, the 332 students ...
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Objective: To compare the effect of lecture and game methods in disaster risk education on high school students' knowledge.Methods: This research was a randomized field trial of educational intervention for high school’s students in Shiraz, Iran. Through cluster sampling, the 332 students were randomly selected and their knowledge was compared in two randomized allocated intervention groups by pretest and posttest. For one group a classic lecture about the basic concepts of disaster risk management were presented. In the other group through a game base method and demonstrations the mentors tried to educate the considered concepts.Results: In this study 332 students were participated in lecture (n=166) and game (n=166) groups. There was a significant increase between the mean of students' knowledge in the two groups of lectures and games method after educational intervention. The mean of students' disaster risk knowledge in the lecture and game methods were 17.47 and 29.77 percent respectively (p<0.001).Conclusion: The game's educational method was more effective than the traditional lecture method on students' knowledge and it can be considered as a new approach for promoting the behaviors on disaster risk management.Clinical Trial Registry: IRCT20171014036766N
Hashem Heshmati; Nasser Behnampour; Golnaz Binaei; Samane Khajavai
Volume 2, Issue 3 , July 2014, , Pages 115-120
Abstract
Objectives: To determine the behavioral pattern of Golestan University of Medical Science (GUMS) students as pedestrian and car occupants in relation to traffic law based on Health Belief Model.Methods: This cross-sectional study was performed during 2012 in GUMS. A total of 370 students of GUMS were ...
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Objectives: To determine the behavioral pattern of Golestan University of Medical Science (GUMS) students as pedestrian and car occupants in relation to traffic law based on Health Belief Model.Methods: This cross-sectional study was performed during 2012 in GUMS. A total of 370 students of GUMS were selected using multi-stage sampling method including stratified and random sampling. Data were collected by using a reliable and valid questionnaire. All the participants filled the questionnaire and the data was extracted according to previously described method. Data were analyzed by using SPSS 18 Software. Descriptive statistic and Spearman correlation was used for analyzing the data.Results: Mean age of the participants was 20.92±1.98 (range 17-32) years. Mean score of perceived susceptibility was 81.87±17.18, being in desirable level. Mean score of perceived severity was 73.39±18.4, being also in desirable level. Mean score of perceived benefits was 77.22 ±16.13, which was also assumed to be in desirable level. Mean score of perceived barriers was 53.46±16.27, assumed as moderate level. In the same way the mean score of practice was 66.17±17.51, so practice in students was in moderate level. Television was the most important cues to action.Conclusion: Perceived susceptibility, perceived severity, perceived benefits regarding safety behaviors was in good level but perceived barriers and behavior was in moderate level and according to the importance of Television, we recommended appropriate intervention such as health education and advocacy, especially through national Television.
Omid Reza Momenzadeh; Seyed Amirreza Mesbahi; Fatemeh sadat Azimi; Mohsen Mardani-Kivi
Volume 10, Issue 3 , July 2022, , Pages 116-121
Abstract
Objective: To evaluate the clinical and radiographic findings of long head biceps tendon (LHBT) transfer intraumatic proximal humeral fractures with the biceps groove breakage or comminution.Methods: In this interventional study, subjects surveyed in terms of shoulder function, clinical signs of LHBTtendinitis, ...
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Objective: To evaluate the clinical and radiographic findings of long head biceps tendon (LHBT) transfer intraumatic proximal humeral fractures with the biceps groove breakage or comminution.Methods: In this interventional study, subjects surveyed in terms of shoulder function, clinical signs of LHBTtendinitis, radiographic signs of transferred biceps as a possible depressor of the shoulder, and mechanicalchanges of the scapula. Data were analyzed in SPSS version 21.Results: Fifteen patients were included in the case group (tendon transfer to the conjoined tendon), and 10patients were evaluated in the control group (non-transfer or non-manipulation of the exposed tendon inthe fracture callus of biceps groove). The mean age of the study population was 46.56±14.31 years, and themajority of patients (14.56%) were men. The differences between two groups were not significant in terms ofthe American Society of Shoulder and Elbow Surgeons (ASES) score, University of California at Los Angeles(UCLA) score, and constant shoulder score (CSS) (p=0.535, p=0.419, and p=0.266, respectively). Also, therewas no significant differences between the case and control groups regarding the biceps muscle involvement(Popeye sign: p=1.00; tenderness: p=0.477; pain: p=1.00; speed test: p=1.00; Yergason’s test: p=1.00).Conclusion: LHBT transfer to the conjoined tendon in proximal humerus fractures with cleavage orcomminution at the bicipital groove showed no advantages.
Homayoun Sadeghi Bazargani; Mohammad Saadati
Volume 4, Issue 3 , July 2016, , Pages 126-133
Abstract
Objective: To systematically identify the various methods of speed management and their effects. Methods: A systematic search was performed in Science Direct, Ovid Medline, Scopus, PubMed and ProQuest databases from April to June 2015. Hand searching and reference of selected articles were used to improve ...
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Objective: To systematically identify the various methods of speed management and their effects. Methods: A systematic search was performed in Science Direct, Ovid Medline, Scopus, PubMed and ProQuest databases from April to June 2015. Hand searching and reference of selected articles were used to improve article identification. Articles published after 1990 which had reported on efficacy/effectiveness of speed management strategies were included. Data were extracted using pre-defined extraction table.Results: Of the 803 retrieved articles, 22 articles were included in this review. Most of the included articles (63%) had before-after design and were done in European countries. Speed cameras, engineering schemes, intelligent speed adaption (ISA), speed limits and zones, vehicle activated sign and integrated strategies were the most common strategies reported in the literature. Various strategies had different effects on mean speed of the vehicles ranging from 1.6 to 10 km/h. Moreover, 8-65% and 11-71% reduction was reported in person injured accidents and fatal accidents, respectively as a result of employing various strategies.Conclusion: Literature revealed positive effects of various speed management strategies. Using various strategies was mostly dependent on road characteristics, driver’s attitude about the strategy as well as economic and technological capabilities of the country. Political support is considered as a main determinant in selecting speed management strategies.
Saurabh Sharma; Mukesh Tiwari; Hemant Chaturvedi
Volume 3, Issue 4 , October 2015, , Pages 128-133
Abstract
Objective: To evaluate the functional outcome and extensor apparatus of operative management of intra-articular fractures of distal humerus using modification of the Triceps Tongue Flap approach.Methods: This prospective study was conducted between June, 2012 to April,2014 in NIMS Medical College and ...
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Objective: To evaluate the functional outcome and extensor apparatus of operative management of intra-articular fractures of distal humerus using modification of the Triceps Tongue Flap approach.Methods: This prospective study was conducted between June, 2012 to April,2014 in NIMS Medical College and Hospital, Jaipur, Rajasthan(India). We included 23 patients with intraarticular fractures of distal humerus that were managed surgically. Modification of Triceps Tongue Flap approach with Triceps flap in inverted ‘V’ shape was used. Follow-up was done using standard radiograph anteroposterior/lateral (AP/Lat) at immediate postoperative day, 1,3, 6 and 12 month intervals. Functional outcome was assessed using range of motion at elbow joint, Disability of Arm, Shoulder and Hand (DASH)Score and Objective Muscle Strength Testing (MRC Grade) of triceps muscle at 1,2, 3,6 and 12 month follow-up.Results: Overall we included 23 patients of whom 16 (69.5%) were men and 7 (30.5%) were women with mean age of 34.6+4.8years. Mean duration of the follow-up was 12.9+1.1 months. Mean DASH Score at final follow up was 7.7+1.1(indicating mild residal impairment). Mean muscle strength at final follow-up was 4.7 ± 0.4 (Range 3 to 5). Mean flexion deformity at elbow was 9.2 ±0.9 (Range 5 to 45) degrees and mean arc of flexion extension as 119 ± 3.4(Range 65to 140) degrees.Conclusion: This approach provides an excellent exposure as well as a good functional outcome as measured by DASH score and full range of motion at the elbow joint with return of almost complete power of the extensor apparatus in patients with intra-articular fractures of distal humerus.
Hamid Rezaei; Ehsan Keykhosravi; Mojtaba Mashhadinejad; Masoud Pishjoo
Volume 9, Issue 3 , July 2021, , Pages 133-137
Abstract
Objective: To investigate the radiological and clinical outcomes of different surgical approaches in cervical spinal trauma in northeastern of Iran. Methods: The present study was conducted retrospectively from January 2011 to December 2017 in Mashhad, Iran. The demographic characteristics, ...
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Objective: To investigate the radiological and clinical outcomes of different surgical approaches in cervical spinal trauma in northeastern of Iran. Methods: The present study was conducted retrospectively from January 2011 to December 2017 in Mashhad, Iran. The demographic characteristics, hospitalization duration, and patient’s surgery detail data were extracted from the patients’ medical records. The follow-up period was at least six months after surgery. Results: This study was conducted on 72 patients and the majority (n=51; 70.8 %) of them were male. Moreover, the participants; mean age was determined at 40.7±16.5 years. In total, 33 (45.8%), 13(18.1%), and 11 patients (15.3%) were operated using the anterior, posterior, and combined approaches in one round, respectively. It should be mentioned that 15 (20.8%) patients underwent the combined approach in two rounds. Early mortality was observed in 22 (30.6%) patients in the admission period. According to the follow-up X-ray results, the type of approach showed no relationship with non-fusion, malalignment, cage subside, and adjacent disk narrowing(p>0.05). Conclusion: According to the obtained results, there was no significant association between neurological and radiological outcomes among approaches. A high mortality rate was noted in combined surgery at one round, and the posterior approach is the best option when our goal is to correct lordosis.
Mohammad Reza Rouhezamin; Shahram Paydar; Maryam Hasirbaf; Shahram Bolandparvaz; Hamid Reza Abbasi
Volume 1, Issue 4 , October 2013, , Pages 141-146
Abstract
Objective: To explain an important aspect of violence, the spatiotemporal pattern of trauma in victims of violence visited in emergency room of Rajaei hospital, Shiraz, IranMethods: This cross-sectional prospective study comprised 109 randomly selected victims of violence visited in emergency room ...
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Objective: To explain an important aspect of violence, the spatiotemporal pattern of trauma in victims of violence visited in emergency room of Rajaei hospital, Shiraz, IranMethods: This cross-sectional prospective study comprised 109 randomly selected victims of violence visited in emergency room of Rajaei hospital, a tertiary referral hospital affiliated to Shiraz University of Medical Sciences in winter 2013. We recorded the demographic information as well as data regarding the type and time of the injuries. The data collected for each victim was then entered in a data gathering form.Results: The study included 88% males with mean age 27.8 ± 8.8 years, which encompassed more than 60% young adults. Our study showed a temporal pattern with triple peaks. Moreover, 64% of assault trauma occurred at night. Furthermore, our study showed the majority of our patients suffered from stab wounds and about 57% of patients studied lacked high school diploma. Moreover it was revealed that violence was more common in downtown Shiraz, especially in the Fifth city district with simultaneous presence of many risk factors for violence.Conclusion: The result of this study showed that age, gender, educational status and temporal peak of violence were shown to be similar to other investigations conducted in other countries. Despite these similarities, stabbing were more prevalent in our study. Additionally, the Fifth city district of Shiraz seems to be the main city district where preventive intervention is needed to reduce violence- related injuries.
Reza Hosseinpour; Amir Barghi; Saadat Mehrabi; Shirvan Salaminia; Paria Tobeh
Volume 8, Issue 3 , July 2020, , Pages 148-155
Abstract
Objective: To investigate the prognosis and survival rates of a group of Iranian patients with traumatic injuries using the trauma and injury severity score (TRISS) model. Methods: In this prospective cohort study, all the patients with multi-trauma referring to the Yasuj Shahid Beheshti hospital during ...
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Objective: To investigate the prognosis and survival rates of a group of Iranian patients with traumatic injuries using the trauma and injury severity score (TRISS) model. Methods: In this prospective cohort study, all the patients with multi-trauma referring to the Yasuj Shahid Beheshti hospital during 2018 were included. The patients’ demographic information, trauma and history of previous illness were recorded. Vital symptoms including respiratory rate, heart rate, hypertension, pulse rate and Glasgow coma scale (GCS) score were assessed. The injury severity score (ISS) was calculated based on the type and location of the injuries and according to the abbreviated injury scale (AIS) classification. The survival probability of the patients was assessed according to the TRISS model. Results: Overall, 252 trauma patients were evaluated out of whom, 195 (77.4%) were men and 57 (22.6%) women. The mean TRISS score was 24.2 ± 9.32 and the maximum score was 99.7. If we consider the TRISS score probability above 0.5 as the chance of being alive, the mortality rate was 6.75%, that was lower than our series (7.1%). The ISS score and GCS had a positive significant relationship with other variables except respiratory rate, body temperature and hospitalization. Revised trauma score (RTS) was significantly associated with other variables including age, GCS, hemoglobin, systolic blood pressure and respiratory rate. TRISS had an area under curve (AUC) of 0.988 indicating a high prognostic accuracy. Conclusion: The mortality rate was lower than that of being predicted by TRISS. This might be due to treatment effectiveness and care for traumatic patients leading to decreased mortality. TRISS had high prognostic accuracy in trauma patients. We also reported an association between hemoglobin and survival rate. Therefore, it seems that considering the laboratory parameters can be useful in patients with trauma.
Abdolkarim Rahmanian; Ali Haghnegahdar; Abdolvahab Rahmanian; Fariborz Ghaffarpasand
Volume 2, Issue 4 , October 2014, , Pages 151-155
Abstract
Objective: To investigate the effects of intracranial pressure (ICP) monitoring on mortality rate and functional outcome of patients with severe traumatic brain injury (TBI).Methods: This was historical cohort study being performed in Nemazee hospital of Shiraz during a 4-year period (from 2006 to 2010) ...
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Objective: To investigate the effects of intracranial pressure (ICP) monitoring on mortality rate and functional outcome of patients with severe traumatic brain injury (TBI).Methods: This was historical cohort study being performed in Nemazee hospital of Shiraz during a 4-year period (from 2006 to 2010) including those patients with severe TBI who had undergone care based on ICP monitoring (case group) or clinical evaluation (control group).Patients and controls were matched regarding the age, sex, initial GCS, initial pupils, and CT findings. The functional outcome, complications and mortality rate were recorded and compared between those who underwent ICP monitoring and those who did not.Results: There was no significant difference between two study groups regarding the baseline characteristics. The rate of meningitis was significantly higher in those who underwent Ventriculostomy and ICP monitoring when compared to those who were managed without ICP monitoring. [14 (23.3%) vs. 7 (11.6%); p=0.041]. We found that the mortality rate (28.3% vs. 11.6%; p=0.172) as well as the frequency of persistent vegetative state (5.0% vs. 5.0%; p=0.998) were comparable between two study groups. However the frequency of severe disability was higher in control group compared to case group (26.7% vs. 15.0; p=0.046). In the same way, the frequency of good recovery (26.7% vs. 15.0; p=0.046) and favorable outcome (51.7% vs. 33.3%; p=0.021) was significantly higher in case group.Conclusion: Care based on ICP monitoring in patients with severe TBI was associated with increased frequency of good recovery and favorable outcome and decreased frequency of moderate disability. However higher meningitis rate was associated with Ventriculostomy and ICP monitoring.
Hossein Hodjati; Sahar Sohrabi Nazari; Seifollah Dehghani Nazhvani; Mohammad Yasin Karami; Bita Geramizadeh
Volume 5, Issue 3 , July 2017, , Pages 160-164
Abstract
Objective: To evaluate the efficacy of the gallbladder for reconstruction of the inferior vena cava in a canine model.Methods: The experimental study was conducted on 5 dogs; an oval window with a diameter of (4×1 cm) was made in the inferior vena cava and then repaired using the autologous gallbladder ...
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Objective: To evaluate the efficacy of the gallbladder for reconstruction of the inferior vena cava in a canine model.Methods: The experimental study was conducted on 5 dogs; an oval window with a diameter of (4×1 cm) was made in the inferior vena cava and then repaired using the autologous gallbladder patch with preservation of gallbladder function. The patency and functionality of the graft were assessed macroscopically and microscopically at 2 months postoperatively.Results: All the dogs were euthanized at 2 months, showing excellent patency of the vena cava macroscopically. In the microscopic examination, all the patches were completely endothelialized. No evidence of infection and inflammation and thrombosis was noted.Conclusion: The gallbladder patch is an available and safe alternate for reconstruction of the inferior vena cava at least in animal model. However, further well designed prospective studies are needed to confirm this hypothesis.
Golnar Sabetian; Hossein Abdolrahimzadeh fard; Mina Ostovan; Sina Azadikhah; Farid Zand; Mansoor Masjedi; Naeimehossadat Asmarian
Volume 10, Issue 4 , October 2022, , Pages 172-180
Abstract
Objective: To compare clinical and paraclinical similarities between trauma patients with positive RT-PCRtests (PCR+ve) and the RT-PCR negative ones (PCR -ve).Methods: This a case-control study, where cases had a PCR+ve and controls had a negative result. Two groupswere compared regarding (para) clinical ...
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Objective: To compare clinical and paraclinical similarities between trauma patients with positive RT-PCRtests (PCR+ve) and the RT-PCR negative ones (PCR -ve).Methods: This a case-control study, where cases had a PCR+ve and controls had a negative result. Two groupswere compared regarding (para) clinical values. Multivariable binary logistic regression analysis investigatedthe variables predicting COVID-19 and the mortality rate.Results: Both groups were similar regarding the clinical findings and comorbidities (p>0.05). PCR+ve grouphad lower lymphocyte count (1.41 [1.45] vs. 1.66 [1.61], p=0.030), CPK level (411 [928.75] vs. 778 [1946.5].p=0.006) and CRP level (17 [42.5] vs. 24 [50.75], p=0.004). However, none of these findings were significant inthe multivariable analysis. Finally, PCR+ve group had increased odds of death (OR=2.88; 95% CI=1.22-7.41).Conclusion: Unlike our primary hypothesis, the study failed to mark any significant (para) clinical featuresguiding us to detect COVID-19 earlier in trauma patients. Moreover, the PCR+ve group is at increased mortalityrisk. A larger, multicentric prospective study should be designed to address this issue.
Ali Meshkini; Amir Ghorbani; Zahra Hasanpour Segherlou; Masoud Nouri-Vaskeh
Volume 9, Issue 4 , October 2021, , Pages 183-187
Abstract
Objective: To examine the GFAP and S100B ability in prevention unnecessary brain CT scan in mTBI and compare them with the single extremity fracture in orthopedic patients. Methods: In this prospective cohort study, two orthopedics patients’ groups and mTBI patients were studied to assess the biomarkers’ ...
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Objective: To examine the GFAP and S100B ability in prevention unnecessary brain CT scan in mTBI and compare them with the single extremity fracture in orthopedic patients. Methods: In this prospective cohort study, two orthopedics patients’ groups and mTBI patients were studied to assess the biomarkers’ ability in prevention unnecessary brain CT scan at the emergency setting. There were 40 orthopedics’ patients with single extremity fracture and 41 mTBI patients. Brain CT scans were done for all mTBI patients. Results: Brain CT scans showed no intracranial traumatic lesions. The median levels for S100B in the mTBI group was 14.8 (4.4-335.9) ng/L, and in orthopedic patients’ group was 13.3 (5-353.10) ng/L. Statistically significant differences were observed between both groups in S100B levels (p=0.006). The median Glial Fibrillary Acidic Protein (GFAP) levels in the mTBI patients’ group were 600 (400-16300) and in the orthopedic patients’ groups was 60 ng/L (300-14900). Statistically significant differences were observed between groups in GFAP (p=0.041). Conclusion: Our results showed that S100B and GFAP serum levels were significantly higher in patients with mTBI than in patients with a single limb fracture.
Hedayat Jafari; Rahmatollah Marzband; Mahsa Kamali; Mahmood Moosazadeh; Pooyan Ghorbani Vajargah; Samad Karkhah; Joseph Osuji; Behzad Davaribina
Volume 11, Issue 4 , October 2023, , Pages 184-189
Abstract
Objective: This study evaluated the occupational burnout (OB) and spiritual well-being (SWB) of emergencynurses as well as the associations between these variables.Method: This cross-sectional study was conducted in six hospitals and emergency medical centers affiliated withArdebil University of Medical ...
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Objective: This study evaluated the occupational burnout (OB) and spiritual well-being (SWB) of emergencynurses as well as the associations between these variables.Method: This cross-sectional study was conducted in six hospitals and emergency medical centers affiliated withArdebil University of Medical Sciences (Ardebil, Iran), in 2020. Data were collected via socio-demographic,Spiritual Well-Being Scale (SWBS), and Maslach Burnout Inventory (MBI) questionnaires.Results: This study included 239 emergency department nurses. The mean age of the participants was 34.4±6.4years. The mean of existential well-being and religious well-being was 40.3±8.7 and 41.0±9.2, respectively. Theresults indicated that moderate (P=0.007) and severe (P<0.001) personal accomplishment was a positive andsignificant predictor of the SWB in emergency department nurses.Conclusion: Proper planning and provision of suitable educational programs in the dimension of the SWBof nurses prevent the creation and continuation of OB and increase the self-efficacy and job satisfaction ofemergency medical staff, resulting in better patient care.
Fatemeh Ranjbar; Fariborz Akbarzadeh; Babak Kazemi; Abdolmohammad Ranjbar; Sonia Sharifi Namin; Homayoun Sadeghi-Bazargani
Volume 4, Issue 4 , October 2016, , Pages 202-210
Abstract
Objective: To determine the type and pattern of arrhythmic events following the 2012 Ahar-Varzegan Earthquake among patients implanted with cardiac defibrillators (ICDs) in East Azarbaijan province.Methods: In a prospective cohort study, conducted in East Azerbaijan Province of Iran, 132 patients were ...
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Objective: To determine the type and pattern of arrhythmic events following the 2012 Ahar-Varzegan Earthquake among patients implanted with cardiac defibrillators (ICDs) in East Azarbaijan province.Methods: In a prospective cohort study, conducted in East Azerbaijan Province of Iran, 132 patients were enrolled in two comparison groups according to the region of residence i.e., earthquake region (n= 98) and non-earthquake (n= 34) region in 2012. Data were collected for those meeting standard criteria for sustained ventricular arrhythmias (VAs), or supraventricular tachycardias (SVTs) and triggered ICD therapies, either shock or anti-tachycardia pacing (ATP). The state version of the State-Trait Anxiety Inventory (STAI-S) was used to assess general symptoms of anxiety in both groups.Results: Males comprised 81.1% of the participants. Mean age of the participants was 59.7 ±15 years. The frequency of patients with sustained VAs increased significantly after the earthquake (p=0.008). There were more VAs (mean 2.16 vs. 6.23; p=0.008) and they occurred earlier (6th vs. 16th day; p= 0.01) in the earthquake area. The mean frequency of SVTs and the total number of delivered ICD therapies were similar between groups. Differences in anxiety levels were not significant between groups but there was a trend for presence of greater number of patients with anxiety (p=0.07) and the relative severity of anxiety (p=0.08) in the earthquake area.Conclusion: In the earthquake area, the mean frequency of VAs increased and they occurred earlier in the earthquake area. The stress of anxiety might have served as a trigger for these events.
Houman Azizizadeh; Alireza Najafpour
Volume 6, Issue 3 , July 2018, , Pages 207-216
Abstract
Objective: To investigate effects of intraperitoneally administration of α-tocopherol loaded nanoparticles (TNP) on ischemia-reperfusion injury in ovaries.Methods: Thirty-five healthy female Wistar rats ~250g were randomized into seven experimental groups (n = 5): Group SHAM: The rats underwent ...
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Objective: To investigate effects of intraperitoneally administration of α-tocopherol loaded nanoparticles (TNP) on ischemia-reperfusion injury in ovaries.Methods: Thirty-five healthy female Wistar rats ~250g were randomized into seven experimental groups (n = 5): Group SHAM: The rats underwent only laparotomy. Group Ischemia: A 3- hour ischemia only. Group I/R: A 3-hour ischemia and a 3-hour reperfusion. Group I/T: A 3-hour ischemia only and 100 mg/kg intraperitoneal administration (IP) of α-tocopherol 2.5 hours after induction of ischemia. Group I/R/T: A 3-hour ischemia, a 3-hour reperfusion and 100 mg/kg IP of α-tocopherol 2.5 hours after induction of ischemia. Group I/TNP: A 3-hour ischemia only and 1 mg/kg IP of TNP 2.5 hours after induction of ischemia. Group I/R/TNP: A 3-hour ischemia, a 3-hour reperfusion and 1 mg/kg IP of TNP 2.5 hours after induction of ischemia. Results: Animals treated with αTNP showed significantly ameliorated development of ischemia and reperfusion tissue injury compared to those of other groups (p=0.001). The significant higher values of SOD, tGSH, GPO, GSHRd and GST were observed in I/R/NC animals compared to those of other groups (p=0.001). Damage indicators (NOS, MDA, MPO and DNA damage level) were significantly lower in I/R/NC animal compared to those of other groups (p=0.001). Conclusion: Intraperitoneal administration of TNP could be helpful in minimizing ischemia-reperfusion injury in ovarian tissue exposed to ischemia.
Homayoun Sadeghi-Bazargani; Morteza Haghighi; Seyed Taghi Heydari; Hamid Soori; Forouzan Rezapour; Seyed Abbas Motevalian; Reza Tabrizi; Minoo Mohammadkhani
Volume 8, Issue 4 , October 2020, , Pages 229-235
Abstract
Objective: Pedestrians are road users vulnerable to traffic injuries and fatalities. This study aimed to develop and validate a pedestrian behavior questionnaire to be used in Iran.Methods: In this cross-sectional study, the initial questionnaire was designed based on the evaluation of previous ...
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Objective: Pedestrians are road users vulnerable to traffic injuries and fatalities. This study aimed to develop and validate a pedestrian behavior questionnaire to be used in Iran.Methods: In this cross-sectional study, the initial questionnaire was designed based on the evaluation of previous studies conducted world-wide or in Iran. The initial pack included 127 items. After the assuring the face validity of the questionnaire, 27 experts’ opinions in the field of traffic was obtained for assessing/improving the content validity. To test the reliability of the questionnaire, the test-retest method and internal consistency assessment were used. To evaluate the structural validity, the Exploratory Factor Analysis (EFA) using the principal component and the Varimax rotation was applied.Results: After completing the face validity and after summarizing the experts’ suggestions, 12 questions were deleted. By calculating the content validity ratio and coefficient, 20 and 17 were removed. Also, the average content validity coefficient regarding relevancy, clarity and overall average were 0.86, 0.88, and 0.87, respectively. The Cronbach’s alpha coefficient was 0.84. In the last stage and according to the results of the factor analysis, five factors violations, distraction, positive behaviors (group1), positive behaviors (group2) and Aggressive behaviors) were identified from the 29-items questionnaire, which explained 98% of the total variance.Conclusion: Considering the necessity of using a verified and validated tool for planning and evaluating effective interventions for pedestrians is inevitable. The tool designed in the study was found to be valid and reliable for use to measure pedestrian’s behavior and planning to modify high-risk behaviors and enhance safe pedestrian behaviors.
Ana Maria Navio Serano; Joaquín Valle Alonso; Gustavo Rene Piñero; Alejandro Rodriguez Camacho; Josefa Soriano Benet; Manuel Vaquero
Volume 7, Issue 3 , July 2019, , Pages 232-239
Abstract
Objective: To investigate the prognostic value of clinical and laboratory tests in prediction of outcome in patients at day 30 post presentation to hospital with shock and to determine the prognostic value of mid regional pro-adrenomedullin (MR-proADM) on mortality prediction at 30 days in the same patient ...
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Objective: To investigate the prognostic value of clinical and laboratory tests in prediction of outcome in patients at day 30 post presentation to hospital with shock and to determine the prognostic value of mid regional pro-adrenomedullin (MR-proADM) on mortality prediction at 30 days in the same patient cohort.Method: This prospective multicenter cohort study analyzed data from patients who had presenting with shock to the emergency departments of eleven urban, tertiary-care University hospitals in Spain between March, 2011 and May, 2011. Recruitment of patients was via convenience sampling. Inclusion criteria included age between 14 and 100 years with clinical diagnostic criteria of shock on admission. Various patient parameters were analysed, such as age, sex, past medical history. Other clinical variables were measured on arrival to hospital, including sequential organ failure assessment score (score SOFA), blood pressure, oxygen saturations, capillary refill time and shock index (SI). Laboratory variables investigated included base excess, MR-proADM, lactate, C-Reactive Protein (CRP) and procalcitonin (PCT).Results: There were 212 patients included in the study from the eleven hospitals involved. The mean age was 72.2 years old and 60.4% of the patients were men. In the discriminant analysis only age, MR-proADM and PCT remained in the final discriminant equation. The separate analysis of MR-proADM showed that, in the non-survivors group, MR-proADM levels are significantly higher than those found in the group of survivors (p<0.001).Conclusion: Age, PCT and MR-proADM were useful to predict short-term mortality in patients presenting to the emergency department shock. This suggests that PCT and MR-proADM in combination with the most common prediction models will improve prognostic value.
Mehdi Dehghani; Negar Azarpira; Vahid Mohammad Karimi; Hamid Mossayebi; Elaheh Esfandiari
Volume 5, Issue 4 , October 2017, , Pages 249-258
Abstract
Objective: To compare the healing process of pressure ulcers treated with cryopreserved human amniotic membrane allograft and routine pressure ulcer care in our hospital.Methods: From January 2012 to December 2013, in a prospective randomized clinical trial (IRCT201612041335N2), 24 patients with second ...
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Objective: To compare the healing process of pressure ulcers treated with cryopreserved human amniotic membrane allograft and routine pressure ulcer care in our hospital.Methods: From January 2012 to December 2013, in a prospective randomized clinical trial (IRCT201612041335N2), 24 patients with second and third stage of pressure ulcers were enrolled in this study. All patients needed split-thickness skin grafts for pressure ulcer-wound coverage. Selected patients had symmetric ulcers on both upper and lower extremities. The patients were randomly divided into two groups: amnion and control. In the amnion group, the ulcer was covered with cryopreserved amniotic membrane and in the control group it was treated with local Dilantin powder application. The duration and success rate of complete healing was compared between the two groups.Results: The study group was composed of 24 pressure ulcers in 24 patients (19 males and 5 females) with a mean age of 44±12.70 years. The demographic characteristics, ulcer area, and underlying diseases were similar in both groups. The early sign of response, such as decrease in wound discharge, was detected 12-14 days after biological dressing. Complete pressure ulcer healing occurred only in the amnion group (p< 0.001). Partial healing was significantly higher in the amnion group (p< 0.03). Healing time in this group was faster than that the control group (20 days versus 54 days). No major complication was recorded with amniotic membrane dressing.Conclusion: Cryopreserved amniotic membrane is an effective biologic dressing that promotes re-epithelialization in pressure ulcers.
Farhad Heydari; Alireza Gholamian; Majid Zamani; Saeed Majidinejad
Volume 6, Issue 4 , October 2018, , Pages 292-299
Abstract
Objective: To evaluate the efficacy and safety of intramuscular ketamine and haloperidol in sedation of severely agitated patients in emergency department (ED).Methods: This randomized, double-blind clinical trial study was performed on agitated patients referring to two university educational hospitals. ...
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Objective: To evaluate the efficacy and safety of intramuscular ketamine and haloperidol in sedation of severely agitated patients in emergency department (ED).Methods: This randomized, double-blind clinical trial study was performed on agitated patients referring to two university educational hospitals. Patients were randomly assigned to receive intramuscular (IM) haloperidol (5 mg) or IM ketamine (4 mg/kg). The primary outcome was time to adequate sedation (AMSS ≤ +1). Secondary outcomes included the need for additional sedatives, required intubation, duration of hospitalization, and side effects. Results: The 90 agitated patients were enrolled. The mean age was 30.37±7.36 years (range 18–56); 74% (67/90) were men. The mean time to adequate sedation in ketamine group (7.73 ± 4.71 minutes) was significantly lower than haloperidol group (11.42 ± 7.20 minutes) (p= 0.005). 15 minutes after intervention, the sedation score did not differ significantly in both groups (Ketamine:0.14 ± 0.59 vs. Haloperidol: 0.30 ± 0.60; p=0.167). The incidence of complications was not significantly different between groups. The physician's satisfaction from the patients’ aggression control was significantly higher in ketamine group.Conclusion: These data suggest ketamine may be used for short-term control of agitated patients, additional studies are needed to confirm if ketamine is safe in this patient population. Given rapid effective sedation and the higher physician satisfaction of ketamine in comparison to haloperidol, it may be considered as a safe and appropriate alternative to haloperidol.IRCT Code: IRCT20180129038549N5
