Zeinab Naderpour; Mehdi Momeni; Elnaz Vahidi; Javad Safavi; Morteza Saeedi
Volume 7, Issue 4 , October 2019, , Pages 361-365
Abstract
Objective: To determine the possible relationship of procalcitonin (PCT) and D-dimer with the 28-day-mortality rate and severity of sepsis based on sequential organ failure assessment (SOFA) score. Methods: In this cross-sectional study, patients were enrolled based on their signs and symptoms of ...
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Objective: To determine the possible relationship of procalcitonin (PCT) and D-dimer with the 28-day-mortality rate and severity of sepsis based on sequential organ failure assessment (SOFA) score. Methods: In this cross-sectional study, patients were enrolled based on their signs and symptoms of sepsis confirmed by essential laboratory studies. Demographic data, Glasgow coma scale and vital signs, serum PCT and D-dimer levels, creatinine, bilirubin level, arterial blood gas analysis and platelet count were recorded. Disease severity index was assessed based on SOFA score. Patients’ 28-day-mortality rate and hospital length of stay were compared with the study variables. Results: Sixty-four patients with the mean age of 78.3±11.6 were included of whom 34 cases (53.1%) were male. The 28-day-mortality rate was 17%. The analysis showed that only patients’ age (p=0.01) and platelet count (p=0.02) had a statistically significant association with the mortality rate. SOFA score had no statistically significant correlation with PCT or D-dimer; and these two markers didn’t have any significant correlation in terms of predicting mortality due to the sepsis. Conclusion: In our study, PCT and D-dimer failed to show any significant correlation with 28-day-mortality rate of sepsis.
Hamid Reza Abbasi; Farnaz Farrokhnia; Sepideh Sefidbakht; Shahram Paydar; Shahram Bolandparvaz
Volume 1, Issue 1 , January 2013, , Pages 17-21
Abstract
Objective: To determine the removal time of the chest tube in ICU trauma patients under positive ventilation pressure (PVP).Methods: This was randomized clinical trial being performed in ICU department of Rajaei trauma hospital from March to December 2011. A total number of 92 trauma patients who were ...
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Objective: To determine the removal time of the chest tube in ICU trauma patients under positive ventilation pressure (PVP).Methods: This was randomized clinical trial being performed in ICU department of Rajaei trauma hospital from March to December 2011. A total number of 92 trauma patients who were admitted in ICU and were under ventilation and had chest tube were randomly assigned into two groups. In case group, chest tube was clamped after 5–7 days. In the control group, chest tube was retained until the patients were under PVP. The chest tube was removed if there was no air leak or the drainage was less than 300 mL.Results: Complications observed in the case and control groups were 4.4% of 4.3% respectively (p=0.862). Among case group with hemothorax, 6.7% developed complication while this ratio for pneumothorax was 7.1% and zero in those with hemopneumothorax (p=0.561), whereas respective values for the control group were 11.1%, 8.3% and zero (p=0.262). Complications were noticed in 10.5% of those with more than 300 ml of pulmonary drainage. There were no complications in patients without air leak. In mild leak, 4.8% of subjects experienced complication, in moderate leak, no complication occurred and in severe ones, complication was visible in 7.7% of patients (p=0.842).Conclusion: The present study showed that the removal of chest tube in patients under ventilation within 5-7 days after its insertion is safe without any complications.
Mehrzad Banihashemi; Azam Safari; Navid Nezafat; Mahmoodreza Tahamtan; Manica Negahdaripour; Negar Azarpira; Younes Ghasemi
Volume 5, Issue 1 , January 2017, , Pages 18-23
Abstract
Objective: To evaluate the effect of fibrin perihepatic packing on controlling liver hemorrhage and liver wound healing.Methods: In this animal experimental study, 20 adult male Sprague Dawley rats, weighing 200-220 g, were included. Stab wound injury was created by number 15 scalpel, so that bilateral ...
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Objective: To evaluate the effect of fibrin perihepatic packing on controlling liver hemorrhage and liver wound healing.Methods: In this animal experimental study, 20 adult male Sprague Dawley rats, weighing 200-220 g, were included. Stab wound injury was created by number 15 scalpel, so that bilateral liver capsules and liver tissue were cut, and acute bleeding was accrued. The animals were divided into 2 study groups: control (with a primary gauze packing treatment) and test group (with fibrin packing treatment). Serum alanine aminotransferase (ALT), aspartate aminotransferase (AST), and total serum bilirubin (TSB) levels were measured as a liver function test during the treatment period. Blood loss was calculated for estimation of hepatic hemorrhage during surgery. After four weeks, the liver wound repair was evaluated by sampling and Hematoxylin and Eosin staining (H&E).Results: In the test group, all of animals were alive (mortality rate= 0%). Significantly, ALT and AST levels were raised after surgery, followed by a decrease ALT (p=0.783) and AST (p=0.947) to the normal level during 4 days. Estimated blood loss was 2.89 ± 0.73 mL (about 19.65% of estimated blood volume). Hematocrit levels returned to the normal level (p=0.109) after 48 hours. In the control group, the mortality rate was 50% during 12h after surgery. ALT (p=0.773) and AST (p=0.853) were decreased to normal level during 6 days, and estimated blood loss was 4.98 ± 0.77 mL (about 32.98% of estimated blood volume) in the remaining animals. Moreover, hematocrit levels returned to the normal level (p=0.432) after 72 hours. Estimated blood loss in the test group was significantly less than control group (p<0.001). Total serum bilirubin levels were not significantly different from the normal level, before and after surgery in both groups. Histopathology sections from the post-hepatectomy specimens showed that the site of the previous incision was completely repaired, and a dense fibrous septum was observed in both groups.Conclusion: The fibrin dressing was effective in preventing blood loss and saving lives after a liver stab injury and major internal bleeding in the animal model of rat.
Mehran Kouchek; kamran Aghakhani; Mostafa Dahmardehei; Azadeh Memarian
Volume 12, Issue 1 , January 2024, , Pages 26-34
Abstract
Objective: This study investigated the demographic characteristics and factors influencing burn injuries,primarily in low socioeconomic societies where such incidents are prevalent due to factors such as illiteracyand poverty.Methods: This cross-sectional study included all burn patients admitted to ...
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Objective: This study investigated the demographic characteristics and factors influencing burn injuries,primarily in low socioeconomic societies where such incidents are prevalent due to factors such as illiteracyand poverty.Methods: This cross-sectional study included all burn patients admitted to Shahid Motahari Hospital inTehran, Iran. Demographic data such as age, sex, occupation, education level, and residence as well as detailedinformation about the burn incidents such as date, time, location, number of people present at the scene, andreferral place was collected. Additionally, comprehensive burn details such as cause, extent, severity, previoushistory, and need for hospitalization directly at the emergency department were documented.Results: The study included 2213 patients (mean age 34.98±19.41 years; range 1-96), with a men predominance(60.6%). The majority of burns (64.4%) occurred at home, primarily due to accidents (99.6%), with boilingwater being the most common cause (39.2%). The most frequent burns were second-degree burns (91.8%),with an average injured body area of 6.31±6.67%. There were significant correlations between burn severityand demographic factors such as age, sex, occupation, cause of burn, hospital admission, outcome, and lengthof stay. Remarkably, the extent of burns was negatively correlated with the distance to the hospital, whilepositively correlated with the length of hospital stay.Conclusion: Burn injuries were significantly influenced by demographic factors. Enhancing treatment facilitiesand reducing the time and distance to medical care could be crucial in high-risk cases.
Masoud Pezeshki Rad; Hassan Ravari; Aria Bahadori; Orkideh Ajami
Volume 2, Issue 1 , January 2014, , Pages 27-31
Abstract
Objective: To determine the etiology, signs and symptoms, angiography indications and angiography findings in patients with limb penetrating injuries suspected to have arterial injury.Methods: This was a cross-sectional study being performed in Imam Reza Hospital affiliated with Mashhad University of ...
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Objective: To determine the etiology, signs and symptoms, angiography indications and angiography findings in patients with limb penetrating injuries suspected to have arterial injury.Methods: This was a cross-sectional study being performed in Imam Reza Hospital affiliated with Mashhad University of Medical Sciences, Iran between September 2011 and March 2013. We included those patients with extremity blunt and penetrating injuries who were referred for angiography according to standard indications including abnormal distal pulses, complex fracture or dislocation, vascular proximity, fixed hematoma, distal nerve deficit, arterial bruit, thrill and massive soft tissue injuries.Results: During the study period, 148 patients (15 women and 133 men) with a mean age of 31±14.9 (11-82) years were evaluated. The most common cause of injury was motor vehicle accident (127 patients 85%). Angiography indications included abnormal distal pulse examination (124, 83.8%), complex fracture or dislocation (7, 4.7%), near arterial trauma (4, 2.7%), fixed hematoma (3, 2%), nerve damage (1, 0.7%). The angiography was found to be normal in 49 (33.1%) patients. In patients with abnormal angiography findings, 60 (60.6%) had cutoff with distal runoff, 21 (21.2%) had cutoff without runoff, 14 (14.1%) had arterial spasm. Other uncommon findings included active bleeding in 2 patients (2%), pseudoaneurysm in 1 (0.7%) and arteriovenous fistula in 1 (0.7%). Out of 4 patients (2.7%) with vascular proximity, only 1 (0.7%) had abnormal angiography.Conclusion: The most important factor in prediction of result of angiography was distal arterial pulses examination. But these data confirm the low incidence of vascular injury in asymptomatic patients with proximity. So the use of angiography when proximity is the sole indication in an asymptomatic patient with a normal vascular examination should be questioned.
Changiz Gholipour; Samad Shams Vahdati; Elmira Ghaffarzade; Keivan Kashi Zonouzi
Volume 3, Issue 1 , January 2015, , Pages 27-31
Abstract
Objectives: To determine the characteristics and etiologies of occupational trauma associated mortality in Tabriz megacity, Northern Iran.Methods: In a cross-sectional study, we included all the recorded cases of occupational mortalities referring to Tabriz forensic medicine center, labor institute and ...
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Objectives: To determine the characteristics and etiologies of occupational trauma associated mortality in Tabriz megacity, Northern Iran.Methods: In a cross-sectional study, we included all the recorded cases of occupational mortalities referring to Tabriz forensic medicine center, labor institute and Imam Reza and Sina hospitals between March 2011 and March 2012. We recorded the demographic and clinical characteristics including age, gender, type of occupational accident, experience of work and permanent or temporary jobs for all the cases. The death etiology was also recorded according to the forensic medicine report. The data are presented as descriptive analytics.Results: Overall we included 32 occupational trauma associated mortality out of whom 30 (93.8%) were men and 2 (6.2%) were women. The mean age of the patients was 44.1 ± 16.3 years old with most of them (31.3%) being younger than 30 years old. The occupation was recorded to be structural in 13 (40.6%), industrial in 5 (15.6%), agricultural in 5 (15.6%) and office work in 6 (18.8%). In 20 (62.5%) patients the occupation was seasonal and in 12 (37.5%) was permanent. Summer was the most common season in which occupational trauma associated mortality was recorded (40.6%) followed by fall by 34.4% of all mortalities. Most frequent causes of occupational traumas were the result of nonuse of safety wares (71.9%), inattention during work time (84.4%) and inappropriate instructions (18.8%).Conclusion: Most of the fatalities occurred in young and less-experienced workers, not having enough attention while working. Regarding this fact we conclude that with continuous education and supervision especially in young workers, most of the occupational accidents are preventable.
Mahnaz Yadollahi; Ali Kashkooe; Reza Rezaiee; Kazem Jamali; Mohammad Hadi Niakan
Volume 8, Issue 1 , January 2020, , Pages 27-33
Abstract
Objective: To compare the injury severity scales as predictors of mortality in trauma patients to search for the best scale.Methods: In a prospective cohort study and systematical random sampling conducted from March to September 2017, trauma patients over the age of 13 years were enrolled. ...
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Objective: To compare the injury severity scales as predictors of mortality in trauma patients to search for the best scale.Methods: In a prospective cohort study and systematical random sampling conducted from March to September 2017, trauma patients over the age of 13 years were enrolled. The investigated variables were age, gender, systolic blood pressure, heart rate, respiratory rate, injured body region, Glasgow Coma Scale (GCS), injury severity score (ISS), revised trauma score (RTS), trauma injury severity score (TRISS) and the outcome.Results: Totally, 1410 trauma patients were followed up, out of which 68.5% were male. The participants’ mean age was 43.5±20.88 years. After adjusting the confounding effects, age over 60 years (OR=7.38, CI [3.91-13.93]), GCSthan 5.5.Conclusion: Our results showed that TRISS, RTS, GCS, and ISS were all very effective approaches for evaluating prognosis, mortality and probable complications in trauma patients; thus, these systems of injury evaluation and scoring are recommended to facilitate treatment. TRISS, RTS, and ISS had almost the same sensitivity that was higher than GCS, but GCS had the most specificity. Finally, TRISS was selected as the most efficient scale for predicting mortality.
Farshad Faghisolouk; Sanaz Sohrabizadeh; Hamid Soori; Davoud Khorasani-zavareh
Volume 9, Issue 1 , January 2021, , Pages 28-35
Abstract
Objective: To explore the factors affecting unsafe antisocial behaviors of drivers in the context of Iran.Methods: The interviews were conducted from June to November 2019. A number of 19 participants were selected using purposive sampling method. The data were collected using face to face in-depth ...
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Objective: To explore the factors affecting unsafe antisocial behaviors of drivers in the context of Iran.Methods: The interviews were conducted from June to November 2019. A number of 19 participants were selected using purposive sampling method. The data were collected using face to face in-depth semi-structured interviews. Content analysis using Granheim’s approach was applied for data analysis.Results: Seven categories and 14 sub-categories were extracted from the data. The categories included cultural factors, educational and training factors, laws, imitating, substance abuse, awareness and attitude, and psychological problems.Conclusion: Based on the findings, various cultural, legal, educational, individual and psychological factors affect the unsafe antisocial behavior in driving. Seemingly, such behaviors could increase the chance of death or injury caused by road traffic crashes among the road users and affect social welfare of the citizens and road user’s safety.
Fatemeh Jahanian; Seyed Mohammad Hosseininejad; Hamed Amini Ahidashti; Farzad Bozorgi; Iraj Goli Khatir; Seyyed Hosein Montazar; Vahideh Azarfar
Volume 6, Issue 1 , January 2018, , Pages 31-36
Abstract
Objective: To compare the effects of intravenous morphine and a low dose of ketamine on pain intensity of patients with traumatic fractures of the long bones.Methods: This randomized, controlled, double-blinded, clinical trial was conducted in the adult emergency department (ED) of Emam Khomeini hospital, ...
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Objective: To compare the effects of intravenous morphine and a low dose of ketamine on pain intensity of patients with traumatic fractures of the long bones.Methods: This randomized, controlled, double-blinded, clinical trial was conducted in the adult emergency department (ED) of Emam Khomeini hospital, a tertiary general hospital affiliated with Mazandaran University of Medical Sciences, in Northern Iran, during a 6-month period. Patients were randomly assigned to receive intravenous morphine (0.1 mg/kg) or low dose ketamine (0.5 mg/kg) for control of the pain in the emergency room. The pain intensity was checked by a nurse using the visual analogue scale (VAS) at 30, 60, 90, 120, 180 and 240, minutes after the intervention.Results: Overall we included a total number of 156 patients with mean age of 35.87±3.38 years. There were 111 (71.2%) men and 4 (28.8%) women among the patients. Patients were randomly assigned to receive intravenous morphine (n=78) or low dose ketamine (n=78). The pain intensity decreased significantly in both study groups after 240 minutes of intervention. However, there was no significant difference between the two study groups regarding the pain intensity at 30 (p=0.378), 60 (p=0.927), 90 (p=0.434), 120 (p=0.557), 180 (p=0.991) and 240 (p=0.829) minutes. The side effects were comparable while low dose ketamine was associated with higher need for rescue analgesic (p=0.036). Conclusion: The results of the current study demonstrates that the intravenous low dose ketamine leads to successful pain control in patients with long bone fractures and the effects are comparable with intravenous morphine.The study is registered with the Iranian Registry for Clinical trials (www.irct.ir; IRCT2017041221480N6)
Atefeh Ghanbari; Sanaz Masoumi; Ehsan Kazemnejadleili; Marjan Mahdavi-Roshan; MohammadReza Mobayen
Volume 11, Issue 1 , January 2023, , Pages 32-40
Abstract
Objectives: To study the anti-inflammatory and antioxidant effects of flaxseed oil and olive oil on inflammatorymarkers for facilitating wound healing.Methods: One hundred and twelve patients were randomly selected to four groups with a total burn surfacearea (TBSA) of 20-50%. The four groups includes ...
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Objectives: To study the anti-inflammatory and antioxidant effects of flaxseed oil and olive oil on inflammatorymarkers for facilitating wound healing.Methods: One hundred and twelve patients were randomly selected to four groups with a total burn surfacearea (TBSA) of 20-50%. The four groups includes olive oil (OO), flaxseed oil (FO), mixture of olive oil andflaxseed oil (OF), and control group and received 30g of oils for three weeks. Serum high-sensitivity C-reactiveprotein (hs-CRP), ferritin and albumin level as inflammatory markers, as well as cholesterol, triglyceride,high-density lipoprotein (HDL) and low-density lipoprotein (LDL) as the lipid profile were explored. Woundhealing was assessed by photographing on days 2, 8, 15, and 22 (during three weeks of intervention) and wereanalyzed in imageJ software.Results: The greatest reduction in the level of hs-CRP and ferritin was observed in the OF (-21.38±44.41)(-132.79±165.36), while the lowest reduction was reported in the control group (-36.36±79.03) (141.08±262.36).Compared to control group, OO significantly increased albumin (0.88±0.65). Reduction of wound healing at theend of the first week of intervention was not significant in the study groups. However, the stereology examinationshowed significant improvement in wound healing at the end of the second and third weeks in the OF.Conclusion: Based on the findings, combination of herbal oils reduce inflammation and improve wound healingand showed positive effects on the size of wounds in burn patients.
Pegah Parhizkar; Rahim Mohammadi; Rasoul Shahrouz; Vahid Mohammadi
Volume 7, Issue 1 , January 2019, , Pages 35-40
Abstract
Objective: To evaluate effects of pyrroloquinoline quinone (PQQ) on ischemia-reperfusion injury using a rat ovary model.Method: Thirty healthy female Wistar rats with 250g were randomized into five experimental groups (n = 6): Group SHAM: The rats underwent only laparotomy. Group Ischemia: A 3- hour ...
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Objective: To evaluate effects of pyrroloquinoline quinone (PQQ) on ischemia-reperfusion injury using a rat ovary model.Method: Thirty healthy female Wistar rats with 250g were randomized into five experimental groups (n = 6): 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. 30 min before termination of reperfusion 20 µL soybeen oil (Solvent of PQQ) was administered. Group I/PQQ: A 3-hour ischemia only and 20 µL (10 mg/kg) intraperitoneal administration (IP) of PQQ 2.5 hours after induction of ischemia. Group I/R/PQQ: A 3-hour ischemia, a 3-hour reperfusion and 20 µL (10 mg/kg) IP of PQQ 2.5 hours after induction of ischemia. Results: Animals treated with PQQ 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, GPO and GST were observed in I/R/PQQ animals compared to those of other groups (p=0.001). Damage indicator (MDA) was significantly lower in I/R/PQQ animal compared to those of other groups (p=0.001). Conclusion: Intraperitoneal administration of PQQ could be helpful in minimizing ischemia-reperfusion injury in ovarian tissue exposed to ischemia.
Alireza Farid Moayer; Navideh Mohebali; Ali Razmkon
Volume 4, Issue 1 , January 2016, , Pages 38-42
Abstract
Objective: To determine the incidence of deep vein thrombosis (DVT) in patients undergoing spinal surgeries receiving prophylactic doses of Deltaparin in a single center in central Iran.Method: This cross-sectional study was conducted in Shariatee hospital of Isfahan during a 12-month period. We included ...
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Objective: To determine the incidence of deep vein thrombosis (DVT) in patients undergoing spinal surgeries receiving prophylactic doses of Deltaparin in a single center in central Iran.Method: This cross-sectional study was conducted in Shariatee hospital of Isfahan during a 12-month period. We included all the patients undergoing elective spinal surgeries in our center during the study period who received prophylactic dosages of subcutaneous Dalteparin (5000 unit daily) the first postoperative day. Those with absolute contraindications of anticoagulation therapy were not included in the study. Patients were followed for 3 months clinically and the incidence of DVT was recorded. DVT was suspected clinically and was confirmed by color Doppler sonography.Results: Overall we included 120 patients with mean age of 44.8 ± 12.6 years among whom there were 54 (45%) men and 66 (55%) women. Lumbar discectomy (32.9%) and laminectomy (20.2%) were the most common performed procedures. DVT was detected in 1 (0.83%) patient in postoperative period. None of the patients developed pulmonary embolism and none hemorrhagic adverse event was recorded. The patient was treated with therapeutic unfractionated heparin and was discharged with warfarin. Conclusion: Our results shows the efficacy of LMWH (Dalteparin) in reducing the incidence of DVT to 0.83%. These results also show the safety of Dalteparin in spine surgery because of lack of bleeding complication.
Hafeezulla Lone; Farooq Ahmad Ganie; Ghulam Nabi Lone; Abdul Majeed Dar; Mohammad Akbar Bhat; Shyam Singh; Khursheed Ahmad Parra
Volume 3, Issue 2 , April 2015, , Pages 59-64
Abstract
Objective: To determine the risk factors, clinical characteristics, surgical management and outcome of pseudoaneurysm secondary to iatrogenic or traumatic vascular injury.Methods: This was a cross-sectional study being performed in department of cardiovascular and thoracic surgery skims soura during ...
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Objective: To determine the risk factors, clinical characteristics, surgical management and outcome of pseudoaneurysm secondary to iatrogenic or traumatic vascular injury.Methods: This was a cross-sectional study being performed in department of cardiovascular and thoracic surgery skims soura during a 4-year period. We included all the patients referring to our center with primary diagnosis of pseudoaneurysm. The pseudoaneurysm was diagnosed with angiography and color Doppler sonography. The clinical and demographic characteristics were recorded and the risk factors were identified accordingly. Patients with small swelling (less than 5-cm) and without any complication were managed conservatively. They were followed for progression and development of complications in relation to swelling. Others underwent surgical repair and excision. The outcome of the patients was also recorded.Results: Overall we included 20 patients with pseudoaneurysm. The mean age of the patients was 42.1±0.6 years. Among them there were 11 (55%) men and 9 (45%) women. Nine (45%) patients with end stage renal disease developed pseudoaneurysm after inadvertent femoral artery puncture for hemodialysis; two patients after interventional cardiology procedure; one after femoral embolectomy; one developed after fire arm splinter injury and one formed femoral artery related pseudoaneurysm after drainage of right inguinal abscess. The most common site of pseudoaneurysm was femoral artery followed by brachial artery. Overall surgical intervention was performed in 17 (85%) patients and 3 (15%) were managed conservatively.Conclusion: End stage renal disease is a major risk factor for pseudoaneurysm formation. Coagulopathy, either therapeutic or pathological is also an important risk factor. Patients with these risk factors need cannulation of venous structures for hemodialysis under ultrasound guide to prevent inadvertent arterial injury. Patients with end stage renal disease who sustain inadvertent arterial puncture during cannulation for hemodialysis should receive compression dressings for 5 to 7 days.
Farooq Ahmad Gaine; Ghulam Nabi Lone; Mushtaq Ahmad Chowdhary; Hafeezula Lone
Volume 1, Issue 2 , April 2013, , Pages 76-80
Abstract
Objectives: The aim of this study was to evaluate the etiology, associated injurers and clinical presentation of post traumatic diaphragmatic hernia.Methods: This study was a cross-sectional study being conducted in the department of Cardiovascular, thoracic surgery (CVTS) and Pediatric Surgery, Sher-i-Kashmir ...
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Objectives: The aim of this study was to evaluate the etiology, associated injurers and clinical presentation of post traumatic diaphragmatic hernia.Methods: This study was a cross-sectional study being conducted in the department of Cardiovascular, thoracic surgery (CVTS) and Pediatric Surgery, Sher-i-Kashmir Institute of Medical Sciences (SKIMS), Srinagar, Kashmir, India. All patients of post traumatic diaphragmatic hernia who were admitted in the department of CVTS and Pediatric Surgery, SKIMS, during the course of study (May 2009 to Nov. 2011) were included.Results: From the commencement of the study 21 patients had traumatic diaphragmatic hernia. Most common presenting symptoms in traumatic diaphragmatic hernia were, chest discomfort and pain abdomen presented in 81% of patients, followed by breathlessness in 61.9% and vomiting in 47.6%. Common associated injuries in traumatic diaphragmatic hernia in our study group were, rib fracture in 47.6%, splenic injury in 28.6%, head injury in 23.8%, soft tissue injury in 23.8%, gut perforation in 19%, limb fracture in 14.3%, liver injury in 9.5%, pancreatic injury in 4.8% and renal injury in 4.8%.Conclusion: Usually the patients of Post traumatic diaphragmatic hernia presents as emergency, early recognition and prompt surgical treatment is needed for better outcome. The Incidence of post traumatic diaphragmatic hernia when associated with blunt trauma abdomen and chest is very high (81%). A high level of suspicion is needed in these injuries. The 9.5% of traumatic diaphragmatic hernia may have delayed presentation. Early diagnosis of traumatic diaphragmatic hernia is most difficult when herniation is delayed.
Omid Aghadavoudi; Hamidreza Shetabi; Hamid Saryazdi; Susan Babayi
Volume 10, Issue 2 , April 2022, , Pages 77-82
Abstract
Objective: To investigate the neck features for laryngeal mask airway (LMA) size selection. Methods: This cross-sectional study was conducted on 160 patients referred for elective surgeries to Feiz Hospital affiliated with Isfahan University of Medical Sciences, Isfahan, Iran (April 2016 to September ...
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Objective: To investigate the neck features for laryngeal mask airway (LMA) size selection. Methods: This cross-sectional study was conducted on 160 patients referred for elective surgeries to Feiz Hospital affiliated with Isfahan University of Medical Sciences, Isfahan, Iran (April 2016 to September 2018). Patients underwent ventilation using LMA whose size was determined through a weighted-based approach. All of the patients’ neck characteristics including circumference, thyromental distance, and opening mouth were measured. Ventilation factors were recorded including numbers of attempts for successful LMA insertion, quality of ventilation, and sealing. Results: Neck circumference and thyromental distance were significantly different with the size of LMA (p 0.05 for all comparisons). However, the thyromental distance was significantly different with the quality ventilation status (p <0.0001). The total assessment of insertion attempts, ventilation efficacy and sealing was significantly different with the neck circumference (p <0.001), but thyromental distance did not show a significant difference (p>0.05). Conclusion: Findings demonstrated that neck circumference might be considered as an appropriate indicator for the selection of LMA size but neither the thyromental distance nor mouth opening. Further studies with a larger sample size are strongly recommended.
Fatemeh Rahmanian; Naser Hatami; Marzieh Haghbeen; Rahim Raofi; Alireza Abbasi; Heshmatollah Shakeri; Poyan Keshavarz; Elham Rafiee; Mahdi Chegin; Esmaeel Rayad doost; Samaneh Abiri; Navid Kalani; Mahdi Foroughian; Mohsen Ebrahimi
Volume 9, Issue 2 , April 2021, , Pages 80-85
Abstract
Objective: To evaluate the clinical and epidemiological features of deceased patients and comparing the discrepancies between male and female patients based on high prevalence of coronavirus disease 2019 (COVID-19), its irreversible effects and the rising mortality rate in Jahrom city. Methods: ...
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Objective: To evaluate the clinical and epidemiological features of deceased patients and comparing the discrepancies between male and female patients based on high prevalence of coronavirus disease 2019 (COVID-19), its irreversible effects and the rising mortality rate in Jahrom city. Methods: This is a descriptive-analytical retrospective study that was conducted from the beginning of March 2020 to the end of November 2020. The study population were included all patients with COVID-19 who admitted to Peymaniyeh Hospital in Jahrom and died of COVID-19. Clinical and demographic data were collected from medical records and analyzed by SPSS software. Results: In this study, 61 patients (57.54%) were men and 45 patients (42.36%) were women. The mean age was 68.7±18.33 in men and 68.82±14.24 in women. The mean hospitalization length was 9.69±7.75 days in men and 9.69±7.75 days in women patients. There was no statistically significant difference between men and women patients (p>0.05). The results showed that 17 (27.87%) men and 28 (45.9%) of women patients had hypertension and the prevalence of this disease was significantly higher in women than men (p=0.01). In this study, 7 (11.48%) men and 13 (21.31%) women had hyperlipidemia. The frequency of hyperlipidemia in women caseswas significantly higher than in men patients (p=0.024). Men cases’ diastolic blood pressure (mean=77.53) was significantly higher than women’s diastolic blood pressure at the same time with a mean of 71.42 (p <0.05). Conclusion: The findings of the study represented the mortality rate in men which is higher than women patients. The prevalence of underlying diseases such as hypertension and hyperlipidemia were higher in women than men. Despite higher mortality among women, symptoms such as fever and dyspnea were less common in women than men.
Elham Safari; Mehdi Torabi
Volume 8, Issue 2 , April 2020, , Pages 83-88
Abstract
Objective: To investigate the relationship between end-tidal CO2 (ETCO2) and serum lactate and their predictive role in hospital mortality of intubated multiple trauma patients. Methods: In a cohort study, intubated multiple trauma patients who referred to the emergency department for two years were ...
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Objective: To investigate the relationship between end-tidal CO2 (ETCO2) and serum lactate and their predictive role in hospital mortality of intubated multiple trauma patients. Methods: In a cohort study, intubated multiple trauma patients who referred to the emergency department for two years were enrolled. After orotracheal intubation using Rapid Sequence Intubation (RSI) method, ETCO2 was immediately measured by capnography. Blood samples for serum lactate measurements were sent to the laboratory, immediately after intubation. Data collection was done using the questionnaire, and the patients were followed using their medical records. Results: Totally, 250 patients were included with hospital mortality of 14.8% (n=37). Using Pearson correlation, an inverse relationship was noticed between serum lactate and ETCO2, immediately (p<0.0001, r=-0.65). In adjusted multivariate analysis, three variables including heart rate (HR), serum lactate and ETCO2 showed a significant relationship with hospital mortality, respectively (p=0.007, p=0.009, p=0.023, respectively). Receiver operating characteristic curve illustrated an area under the curve (AUC) of 0.93, 0.96, and 0.97 for HR, lactate, and ETCO2, respectively. Conclusion: ETCO2 post-intubation and serum lactate may be considered as prognostic factors for intubated multiple trauma patients referring to the emergency department, which can give the clinician an important clue in early prediction of the hospital mortality.
Iman Deilamy; Mitra Amini; Hamid Reza Abbasi; Shahram Bolandparvaz; Shahram Paydar
Volume 10, Issue 2 , April 2022, , Pages 83-86
Abstract
Objective: To investigate the impact of peer-assisted learning (PAL) in chest tube insertion education on surgical residents. Methods: This study is a quasi-experimental study conducted on thirty general surgeon residents enrolled in the PAL program. They were divided into two learner groups (A and B) ...
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Objective: To investigate the impact of peer-assisted learning (PAL) in chest tube insertion education on surgical residents. Methods: This study is a quasi-experimental study conducted on thirty general surgeon residents enrolled in the PAL program. They were divided into two learner groups (A and B) based on the period of residency start. Group A and B had six and one months of general surgery residency experience, respectively. All participants received adequate training for chest tube insertion by a recently graduated general surgeon. Chest tubes insertion skill was assessed using the tool for assessing chest tube insertion competency (TACTIC) test. Results: Post-TACTIC test score was significantly higher (p=0.001) than Pre-TACTIC test score in both groups. However, a comparison of mean Pre-TACTIC test scores and mean Post-TACTIC test scores between group A and group B showed that PAL effectiveness in group A was significantly higher (p=0.001) than group B. Conclusion: There was a positive relationship between the PAL program and the improvement of chest tube insertion technical skills in surgical residents. Based on our findings and similar studies, it can be concluded that the PAL program can increase the chest tube insertion skill of surgical residents.
Ali Davoudi-kiakalayeh; Reza Mohammadi; Shahrokh Yousefzade-Chabok
Volume 2, Issue 2 , April 2014, , Pages 86-91
Abstract
Objective: To investigate maternal beliefs, practices about causes and determinant factors on drowning and maternal socioeconomic correlated factors on child mortality from drowning.Methods: From March 2005 to March 2009, in a register-based cohort study and household survey, individual records utilizing ...
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Objective: To investigate maternal beliefs, practices about causes and determinant factors on drowning and maternal socioeconomic correlated factors on child mortality from drowning.Methods: From March 2005 to March 2009, in a register-based cohort study and household survey, individual records utilizing drowning registry data of northern Iran were enrolled. Mothers (n=276) who responded to multiple questions in a household survey were included. The patterns, interrelationships and effects of socioeconomic correlated factors on child mortality were analyzed.Results: Children drowning mortality among youngest and oldest groups was positively and significantly correlated with family income (p=0.841), mother’s educational level (p=0.482) and age (p=0.414). Participants in household survey also reported that establishment of a multi-sectorial collaboration, integration of public health messages into local television, additional rescue stations and lifeguard, hazard environment fencing, increasing adult supervision, more support on increasing swimming ability among the children were all effective on reducing of drowning death.Conclusion: Due to the high rate of drowning in children and lack of attention among olders, a greater emphasis should be placed on educating mothers to assist a better supervision on their children.
Morteza Rahbar Taramsari; Mohammadreza Mobayen; Mojdeh Esmailzadeh; Alireza Feizkhah; Negin Letafatkar; Sara Hoseinzadeh; Farank Yeganehdoost; Parissa Bagheri; Fatemeh Mehdipour
Volume 11, Issue 2 , April 2023, , Pages 90-95
Abstract
Objective: Burn trauma is a life-threatening incident that may be accompanied by several risk factors thatincrease morbidity and mortality. Drug abuse is one of the lifestyle dangers on the rise globally and can havean impact on the outcomes of burn injuries. This study aimed to evaluate the effect of ...
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Objective: Burn trauma is a life-threatening incident that may be accompanied by several risk factors thatincrease morbidity and mortality. Drug abuse is one of the lifestyle dangers on the rise globally and can havean impact on the outcomes of burn injuries. This study aimed to evaluate the effect of drug abuse on the clinicaloutcomes of adult burn patients who were admitted to a burn center in the North of Iran.Methods: This retrospective cross-sectional study included adult burn patients who were referred to VelayatHospital, between March 1, 2021, and March 20, 2022. The hospital information system (HIS) was used toselect patients with a history of drug use and then were compared with burn victims who had never used drugsbefore. In both groups, demographic information, the cause of the burn, the comorbid diseases, total bodysurface area, length of stay, and outcomes were collected and recorded for both groups.Results: This study included 114 inpatients, 90 of whom (78.95%) were men. The mean age of the patients was43±15 years. The mean length of hospitalization in the drug-user group was significantly higher than in thenon-drug abuse group (p=0.004). The drug abuse group had significantly higher rates of comorbid diseases(p=0.021), inhalation injury (p<0.001), mortality (p=0.002), and pneumonia (p<0.001). However, there were nostatistically significant differences in the Infection and Sir’s rates (p=0.583) between the groups.Conclusion: Drug abuse is a risk factor in adult burn patients, which can affect the length of stay and burnrelated morbidities.
Pallavi Sarji Uthkarsh; Gopalkrishna Gururaj; Sai Sabharish Reddy; Mandya Siddalingaiah Rajanna
Volume 4, Issue 2 , April 2016, , Pages 93-100
Abstract
Objective: To assess the availability of trauma care services in a district referral hospital of Southern India.Methods: This was a cross-sectional study being performed during 2013 in a tertiary healthcare centre in Southern Indian. A detailed assessment of trauma care services was done in a 400 bed ...
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Objective: To assess the availability of trauma care services in a district referral hospital of Southern India.Methods: This was a cross-sectional study being performed during 2013 in a tertiary healthcare centre in Southern Indian. A detailed assessment of trauma care services was done in a 400 bed speciality hospital which is an apex referral hospital in the public health system using a check list based on WHO guidelines for evaluation of essential trauma care services, along with in-depth interviews of hospital stake holders and key informants.Results: The hospital had physical infrastructure in terms of emergency room, inpatient wards, operation theatres, intensive care unit and blood bank facilities. The recently constructed designated building for trauma care services was not operational and existing facilities were used beyond capacity. A designated trauma team was lacking and speciality services for managing polytrauma were deficient and thus, existing personnel were performing multiple tasks. Neurosurgeons and rehabilitative nursing staff were unavailable, and a radiographer was not available on a 24/7 basis. Existing nursing personnel had not received any formal training in trauma care and standard operating protocols were not available for trauma care. Resources for acute resuscitation were partially adequate. The hospital lacked adequate resources to manage head, abdomen, chest and spine injuries, and most of the polytrauma cases were referred to nearby city hospitals.Conclusion: District hospital, the only referral hospital in public health system for trauma victims of that region, had inadequate resources to manage trauma victims, which was probably responsible for delay in trauma care, improper referrals, high cost of care and poor outcomes.
Maryam Tasbih-Forosh; Leila Zarei; Ehsan Saboory; Mehran Bahrami-Bukani
Volume 5, Issue 2 , April 2017, , Pages 96-103
Abstract
Objective: To assess the effect of combination of pulsed electromagnetic fields (PEMF) with predatory stress on transected sciatic nerve regeneration in rats. Methods: In sham- operated group (SOG) the nerve was manipulated and left intact. The 10-mm rat sciatic nerve gap was created in rats. In ...
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Objective: To assess the effect of combination of pulsed electromagnetic fields (PEMF) with predatory stress on transected sciatic nerve regeneration in rats. Methods: In sham- operated group (SOG) the nerve was manipulated and left intact. The 10-mm rat sciatic nerve gap was created in rats. In transected group (Transected) nerve stumps were sutured to adjacent muscle and in vein graft group (VG) the gap was bridged using an inside-out vein graft. In VG/PEMF group the transected nerve was bridged using vein graft, phosphate buffered saline was administered into the graft and the whole body was exposed to PEMF. In VG/PS group the transected nerve was bridged using vein graft, phosphate buffered saline was administered into the graft and the rats underwent predatory stress (PS). In VG/PEMF/PS group the transected nerve was bridged using vein graft, phosphate buffered saline was administered into the graft, the whole body was exposed to PEMF and the rats underwent predatory stress. The regenerated nerve fibers were studied within 12 weeks after surgery.Results: Functional, gastrocnemius muscle mass findings and morphometric indices confirmed faster recovery of regenerated axons in VG/PEMF and VG/PEMF/PS groups compared to those in the other groups (p=0.001). The whole body exposure to PEMF improved functional recovery. Predatory stress did not affect nerve regeneration in the animals undergone predatory stress (p=0.343). Conclusion: Pulsed electromagnetic fields could be considered as an effective, safe and tolerable treatment for peripheral nerve repair in clinical practice.
Saman Nikeghbalian; Homeira Vafaei; Farid Moradian; Kourosh Kazemi; Nader Tanideh; Leila Shayan; Zahra Nikeghbalian
Volume 3, Issue 3 , July 2015, , Pages 97-103
Abstract
Objectives: To investigate the effects of intravenous infliximab in preventing the formation of peritoneal adhesions in an animal model of rat.Methods: This was an experimental study being performed in animal laboratory of Shiraz University of Medical Sciences during 2012. Sixty albino rats were randomly ...
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Objectives: To investigate the effects of intravenous infliximab in preventing the formation of peritoneal adhesions in an animal model of rat.Methods: This was an experimental study being performed in animal laboratory of Shiraz University of Medical Sciences during 2012. Sixty albino rats were randomly assigned in to three groups by Random Design Method. The first group received single infliximab injection (n=20), the second one received double infliximab injection (n=20) and the third received nothing (n=20), after receiving intra-peritoneal injection of talc for induction of peritoneal adhesions. All the animals were sacrificed after 6 weeks and the peritoneal adhesions were evaluated according to Nair classification.Results: We observed that the mean adhesion grade was lower in those who received double dose of infliximib when compared to single dose and controls. However the difference did not reach a significant value (p=0.178). The grade of peritoneal adhesion was also comparable between the three study groups (p=0.103). The mean number of 1st WBC count was also comparable between three study groups (p=0.382). We observed that 2nd WBC count was also comparable between two study groups (p=0.317).Conclusion: Administration of intravenous infliximab after intraabdominal surgicalprocedures would not prevent the formation of peritoneal adhesions in animal model of albino rat.
Mojtaba Karimipour; Sara Shojaei Zarghani; Majid Mohajer Milani; Hamid Soraya
Volume 6, Issue 2 , April 2018, , Pages 115-121
Abstract
Objective: To explore the effects of pre versus post ischemic treatment with metformin after global cerebral ischemia in rats.Methods: Male Wister rats underwent forebrain ischemia by bilateral common carotid artery occlusion for 17 min. Metformin (200 mg/kg) or vehicle was given orally by gavage for ...
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Objective: To explore the effects of pre versus post ischemic treatment with metformin after global cerebral ischemia in rats.Methods: Male Wister rats underwent forebrain ischemia by bilateral common carotid artery occlusion for 17 min. Metformin (200 mg/kg) or vehicle was given orally by gavage for 7-14 days. Rats were divided into: control, metformin pre-treatment, metformin post-treatment and metformin pre and post continuous treatment groups. Cerebral infarct size, histopathology, myeloperoxidase and serum malondialdehyde were measured 7 days after ischemia.Results: Histopathological analysis showed that metformin pre-treatment significantly decreased leukocyte infiltration, myeloperoxidase activity and also malondialdehyde level. Metformin pre-treatment and metformin post-treatment reduced infarct size compared with the control group, but it was not significant in the pre and post continuous treatment group.Conclusion: Our findings suggest that pre-treatment with metformin in comparison with post-treatment in experimental stroke can reduce the extent of brain damage and is more neuroprotective at least in part by inhibiting oxidative stress and inflammation.
Amene Sabzi Sarvestani; Mehdi Zamiri; Mehdi Sabouri
Volume 1, Issue 3 , July 2013, , Pages 116-122
Abstract
Objectives: To describe the characteristics and prognostic factors of 28 patients with Fournier’s Gangrene (FG) referred to our medical center at Southeastern Iran.Methods: This was a cross-sectional study including 28 cases of FG that were operated in Surgery department of Zahedan University of Medical ...
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Objectives: To describe the characteristics and prognostic factors of 28 patients with Fournier’s Gangrene (FG) referred to our medical center at Southeastern Iran.Methods: This was a cross-sectional study including 28 cases of FG that were operated in Surgery department of Zahedan University of Medical Sciences during a 10-year period from April 2002 to March 2012. The study analyzed 9 parameters including the body temperature, heart rate, respiratory rate, hematocrit, white blood count (WBC), and serum levels of sodium, potassium, creatininee (twice for 2 for acute renal failure), and bicarbonate for Fournier Gangrene Severity Index (FGSI) score. The aspects taken into account were age, gender, predisposing factors, duration of symptoms, hospitalization period, and number of debridements, disease outcome and the FGSI.Results: All patients were males, aged from 26 to 68 years, with mean age 44.6 ±8.49 years. Statistically significant differences in age (p<0.001), duration of symptoms (p=0.001), number of debridements (p=0.006), hospitalization duration (p<0.001) and FGSI (p<0.001) were found between surviving and dead patients. The mortality rate was 35.7%, and the most common presentation was perianal/scrotal pain (78.6%). Perianal and primary scrotal abscesses were most common causes of FG and were found in 57.14% and 21.42% of patients respectively. The most prevalent predisposing factor was diabetes mellitus in 12 (42.85%) patients. With respect to laboratory findings, statistically significant differences in WBC (p=0.002), creatinine (p<0.001), albumin (p<0.001), calcium (p<0.001) and serum sodium (p=0.035) were found between the surviving and dead patients.Conclusion: Serious outcome of FG was associated with old age, delayed diagnosis and treatment, inadequate surgical debridement, shorter hospitalization and higher FGSI scores. In addition higher WBC, higher creatininee and serum sodium and lower albumin and calcium levels implicated worse prognosis.
