Shiraz University of Medical SciencesBulletin of Emergency And Trauma2322-25223Issue 420151001Preparedness for Chemical Threats; New Challenges in Management of Trauma and Disasters11511744297ENAmirKhorram-Manesh0000-0002-2734-5733Journal Article20151005https://beat.sums.ac.ir/article_44297_d0cf1b300b84414f12e33c028e7004dc.pdfShiraz University of Medical SciencesBulletin of Emergency And Trauma2322-25223Issue 420151001Necessity of Defining Different Transfusion Protocols for Different Kinds of Trauma Injuries11812144298ENShahramPaydar0000-0002-6980-2576GolnarSabetianZahraGhahramaniBSc, Trauma Research Center, Shiraz University of Medical Sciences, Shiraz, Iran0000-0002-7394-952XSeyed MohsenMousaviHosseinaliKhaliliHamid RezaAbbasi0000-0002-2016-9060ShahramBolandparvaz0000-0002-8875-5998Journal Article20150831https://beat.sums.ac.ir/article_44298_764b1309b1db3fa9b70bc175da764ccf.pdfShiraz University of Medical SciencesBulletin of Emergency And Trauma2322-25223Issue 420151001Effects of Unilateral Iatrogenic Vas Deferens Trauma on Fertility: An Experimental In Vitro Fertilization Mice Model Study12212744299ENMohammadBabaeiUrmia UniversityGholamrezaNajafiUrmia UniversityAliShalizar JalaliUrmia UniversityMehdiBehfarUrmia UniversityJournal Article20150615Objective: To determine bilateral effects of unilateral iatrogenic vas deferens trauma (UIT) on epididymal sperm characteristics and in vitro fertilizing capacity in an experimental mouse model.Methods: Experiments were performed on three equal groups each comprising six adult male mice. Following anaesthesia, UIT was induced by clamping left vas deferens with a mosquito clamp in fully locked fashion for 2 minutes in UIT group. Control-sham mice only had exposure of the left vas deferens through a groin incision. Control animals only received ceftriaxone (100 mg/kg) intraperitoneally at the day of experimental UIT induction. Ipsilateral and contralateral epididymal sperm characteristics and in vitro fertilizing capacity were evaluated after 35 days.Results: UIT significantly decreased sperm concentration, motility and viability as well as fertilization, two-cell embryos, blastocysts and hatched blastocysts rates. Moreover, incidence of DNA damage and abnormality in spermatozoa was significantly higher in UIT group.Conclusion: The findings suggest that a non-recognized iatrogenic vas deferens trauma may have detrimental effects on spermatozoa leading to infertility.https://beat.sums.ac.ir/article_44299_e84ac986cd1dd499de788893aa49f7b5.pdfShiraz University of Medical SciencesBulletin of Emergency And Trauma2322-25223Issue 420151001Management of Intrarticular Fractures of Distal End of Humerus using Modification of the Triceps Aponeurosis Tongue Approach12813344300ENSaurabhSharmaResident M.S Orthopaedics
NIMS University,RajasthanMukeshTiwariProfessor Orthopaedics
NIMS University,RajasthanHemantChaturvediB-201, Ashiana Greens,BhiwadiJournal Article20150722Objective: 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.https://beat.sums.ac.ir/article_44300_10bcef13be9a513dd997ea669fd8e787.pdfShiraz University of Medical SciencesBulletin of Emergency And Trauma2322-25223Issue 420151001Inter-rater Reliability of Triages Performed by the Electronic Triage System13413744301ENFaramarzPourasgharRoad Traffic Injury Research Center and Department of Medical Informatics, School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, IranAminDaemiHealth Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran
and
Iranian Center of Excellence in Health Management, Tabriz University of Medical Sciences, Tabriz, IranJafar SadeghTabriziHealth Services Management Research Center, School of Health management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, IranAlirezaAlaDepartment of Emergency Medicine, School of Medicine, Tabriz University of Medical Sciences, Tabriz, IranJournal Article20150708Objective: To examine the inter-rater reliability of triages performed by the Electronic Triage System (ETS) which has recently developed and used in hospital emergency department (ED).Methods: This cross-sectional study was conducted prospectively and studied 408 visitors of Tabriz Imam Reza hospital’s ED. The variables of interest were age, sex, nurse-assigned triage category, physician-assigned triage category, disease type (trauma, non-trauma), and the referred room within the ED. Cohen’s un-weighted kappa, linear weighted kappa, and quadratic weighted kappa were used to describe the reliability.Results: Un-weighted kappa observed to be 0.186 (95% CI: 0.123-0.249). Linear weighted kappa observed as 0.317 (95% CI: 0.251-0.384) and quadratic weighted kappa as 0.462 (95% CI: 0.336-0.589). In general, low agreement was seen between the triage nurses and ED physicians. For trauma patients and for those who were referred to the cardiopulmonary resuscitation room (CPR), all three types of kappa were higher than other visitors of the ED.Conclusion: Inter-rater reliability of the triages performed by the ETS observed as ranging from poor to moderate. Implementing interventions that would create a common language between nurses and physicians about the triage of the ED visitors seems necessary. The more agreement on the triage of trauma and CPR patients might be due to their condition and the more attention to them.https://beat.sums.ac.ir/article_44301_d939716a141bc82980af3e18884c776b.pdfShiraz University of Medical SciencesBulletin of Emergency And Trauma2322-25223Issue 420151001Correlation between Success Rates of Cardiopulmonary Cerebral Resuscitation and the Educational Level of the Team Leader; A Cross-Sectional Study13814344302ENShahramBolandparvazTrauma Research Center, Shiraz University of Medical Sciences, Shiraz, Iran0000-0002-8875-5998HamidMohajerTrauma Research Center, Shiraz University of Medical Sciences, Shiraz, IranMansoorMasjediassisstant professor of anesthesia , shiraz anesthesiology and critical care research centerEhsanMohammadhoseiniTrauma Research Center, Shiraz University of Medical Sciences, Shiraz, IranLeilaShayanTrauma Research Center, Shiraz University of Medical Sciences, Shiraz, Iran0000-0003-2357-0690Journal Article20150527Objectives: To determine the correlation between the success rates of the cardiopulmonary cerebral resuscitation (CPCR) and the team’s leader education and skill level in Shiraz, southern Iran.Method: This cross-sectional study was conducted during a 6-month period from October 2007 to March 2008 in Nemazee hospital of Shiraz. We included all the patients who underwent CPCR due to cardiopulmonary arrest in emergency room of Nemazee hospital during the study period. We recorded the rates of return of spontaneous circulation (ROSC) and discharge rate (DR) of all the patients. The correlation between these two parameters and the team leader’s education and skill level was evaluated.Results: Overall we included total number 600 patients among whom there were 349 men (58.1%) and 251(41.8%) women with mean age of 58.9±42.6. We found that 270 (45.1%) patients had ROSC, while 330 (54.9%) patients died. Overall 18 (6.6%) patients were discharged from hospital (3% of all participants). We found that the ROSC was significantly higher in those with specialist leader (anesthesiologist or pediatrician) when compared to those in whom CPCR was conducted by technicians (55.2% vs. 30.7%; p=0.001).Conclusion: Conducting CPCR by persons with higher medical degrees resulted in higher rate of ROSC but not in more discharge rate. Inspite of the fact that the rate of ROSC following CPCR was closely analogous to that of developed countries, discharge rate was lower. This indicates that in our region, much more attention needs to be paid to post-resuscitation care and organizing training programs and to cover more resuscitation by CPCR team, conducted by the specialists.https://beat.sums.ac.ir/article_44302_db341afb0fc0fec0f3348f5626b0c7b5.pdfShiraz University of Medical SciencesBulletin of Emergency And Trauma2322-25223Issue 420151001Gangrenous Appendicitis: A Rare Presentation of Pericecal Hernia; Case Report and Review of the Literature14414744303ENShaileshKumarProfessor, Department of General Surgery, PGIMER & Dr. RML Hospital, New Delhi 1, IndiaPriyadarshiDikshitResident, Department of General Surgery, PGIMER & Dr. RML Hospital, New Delhi 1, IndiaShubhenduBhaduriResident, Department of General Surgery, PGIMER & Dr. RML Hospital, New Delhi 1, IndiaSwatiSattavanSenior Resident, Department of General Surgery, PGIMER & Dr. RML Hospital, New Delhi 1, IndiaJournal Article20150809Intra-abdominal Hernias are rare conditions usually secondary to congenital defects, with pericecal hernias accounting for a minority of them. They can be difficult to diagnose due to non-specific presentations but may lead to strangulation and thus require early management. We herein report a rare case of pericecal hernia with gangrenous appendicitis in an 88 year-old lady presenting with features of acute intestinal obstruction and right iliac fossa lump, which on exploration was found to be a pericecal hernia with knotting, strangulation, and gangrenous changes of appendix. This case highlights the need of a high index of suspicion for internal hernias and that of prompt operative intervention to avoid enterectomies and to improve outcome.https://beat.sums.ac.ir/article_44303_ffccb9ed7d2a01253b1d6b550f75afd5.pdf