Review Article
Maryam Kazem Pour; Fariba Shokri; Mehdi Shokri
Articles in Press, Accepted Manuscript, Available Online from 01 July 2025
Abstract
Objective: Allergic respiratory and pulmonary emergencies, though uncommon, represent a potentially lethal risk in dentistry, and anaphylaxis is the cause of a significant percentage of perioperative allergic reactions. If left uncorrected, it increases the mortality rate.Methods: Systematic review according ...
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Objective: Allergic respiratory and pulmonary emergencies, though uncommon, represent a potentially lethal risk in dentistry, and anaphylaxis is the cause of a significant percentage of perioperative allergic reactions. If left uncorrected, it increases the mortality rate.Methods: Systematic review according to PRISMA guidelines with a literature search in PubMed, Scopus, Web of Science, Cochrane Library, and Embase (2000–2025). 47 studies were considered for analyzing allergens, treatment protocols, and preventive interventions. Data synthesis and extraction were conducted, and study quality was assessed using standardized tools.Results: Local anesthetics (such as lidocaine), latex, antiseptics (such as chlorhexidine), and dental materials (such as methacrylates) were identified by the review to be the most common allergens responsible for respiratory allergic emergencies. IgE-mediated reactions (such as anaphylaxis) were demarcated from non-IgE-mediated reactions, and epinephrine was revealed to be the drug of choice for first-line use in anaphylaxis. Preoperative allergy screening, premedications, and material substitution were proven to be preventive measures. Reasonable gaps in the training and preparedness of dental personnel to manage allergic emergencies were identified.Conclusion: Even though there are effective emergency protocols available, widespread implementation of universally standardized response procedures, mandatory simulation training, and enhanced preoperative risk assessment is overdue if patient safety is to evolve.
Original Article
Mohammad Mmohammadifard; Kowsar Ali Akbari; Pooyan Ahanrobai; Aminollah Vasigh
Articles in Press, Accepted Manuscript, Available Online from 01 July 2025
Abstract
Objectives: This randomized controlled trial aimed to evaluate the effect of pre-extubation intravenouslidocaine (1 mg/Kg) on the incidence of airway complications and hemodynamic stability in patients undergoingemergency laparoscopic cholecystectomy, while accounting for age differences.Methods: The ...
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Objectives: This randomized controlled trial aimed to evaluate the effect of pre-extubation intravenouslidocaine (1 mg/Kg) on the incidence of airway complications and hemodynamic stability in patients undergoingemergency laparoscopic cholecystectomy, while accounting for age differences.Methods: The study was a prospective, single-center, randomized controlled trial conducted from 2021 to 2023at Imam Khomeini Hospital, Ilam, Iran. Ninety patients undergoing emergency laparoscopic cholecystectomywere classified into two age groups (<50 and ≥50 years) and randomly assigned to receive either intravenouslidocaine (1 mg/Kg) or a standard extubation protocol. The primary outcomes included post-extubationairway complications, such as laryngospasm, cough, and sore throat, and the secondary outcomes includedhemodynamic and respiratory parameters.Results: Lidocaine produced hemodynamic effects that differed by age group. In patients <50 years, systolicblood pressure (SBP) increased from 129.2±16.4 mmHg to 133.1±23.1 mmHg, while diastolic blood pressure(DBP) rose from 83.9±14.4 mmHg to 92.3±19.4 mmHg (both p<0.001). Conversely, in patients ≥50 years old,SBP decreased from 160.5±26.7 mmHg to 145.2±19.7 mmHg, and DBP decreased from 107.9±19.5 mmHg to99.0±16.1 mmHg (both p<0.001). Airway complications exhibited non-significant tendencies, with a decreasedincidence of cough in the older age group (15.6% vs. 31.8%) and an absence of laryngospasm in this age group.There were no serious adverse events (e.g., bronchospasm, arrhythmias).Conclusion: Intravenous lidocaine was safe and demonstrated a trend toward reducing airway complicationsat extubation in patients undergoing emergency laparoscopic cholecystectomy, particularly in elderly patients.However, this trend did not reach statistical significance, most likely due to insufficient statistical power.
Original Article
Aliasghar Kousari; Amir Mehrvar; Seiied Hossein Heidari; soroush Rezaei Garjaei
Articles in Press, Accepted Manuscript, Available Online from 01 July 2025
Abstract
Objectives: Chevron osteotomy could be fixed using various techniques, each yielding different outcomes.This study aimed to determine the complications and outcomes caused by Chevron osteotomy fixed withtension band wire in distal humeral fractures.Methods: In this prospective study, patients with distal ...
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Objectives: Chevron osteotomy could be fixed using various techniques, each yielding different outcomes.This study aimed to determine the complications and outcomes caused by Chevron osteotomy fixed withtension band wire in distal humeral fractures.Methods: In this prospective study, patients with distal intra-articular humerus fractures treated by Chevronosteotomy at Shahid Rajaei and Shahid Chamran Hospitals (Shiraz, Iran) from October 2018 to October2023 were enrolled. Osteotomy fusion was evaluated radiographically using the Picture Archiving andCommunication System (PACS). Additional complications were assessed during periodic patient follow-ups.Results: The study included 60 patients with a mean age of 44.6±18.14 years, including 23 (38.3%) women. Allcases demonstrated complete union of the olecranon osteotomy, with no cases of infection or fixation failure. Inthree cases, the applied pins and wires were removed. Hardware-related irritation was observed in 22 patients(36.7%).Conclusion: The tension band wiring (TBW) method demonstrated acceptable clinical outcomes. Despitefrequent hardwire irritation, this technique achieved high rates of bony union. However, future comparativestudies evaluating multiple fixation techniques within a single center are warranted.
Original Article
Mehdi Sarafi; Behzad Azimi; Mohammad Karimian; Gholamreza Ebrahimiseraj
Articles in Press, Accepted Manuscript, Available Online from 01 July 2025
Abstract
Objective: This study aimed to investigate the incidence and risk factors for surgical site infection (SSI)following appendectomy.Methods: This retrospective cohort study examined the records of 180 patients who underwent appendectomyin Emam Khomeini Hospital from January 2021 to December 2022. The research ...
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Objective: This study aimed to investigate the incidence and risk factors for surgical site infection (SSI)following appendectomy.Methods: This retrospective cohort study examined the records of 180 patients who underwent appendectomyin Emam Khomeini Hospital from January 2021 to December 2022. The research tool included a demographicprofile form and a research checklist. After obtaining the ethical approval from the university, the researchervisited the hospital and extracted the required data from the patient’s clinical file (in accordance with theresearch checklist). Then, the collected data were entered into SPSS software (version 21) for data analysis.Results: Of the 180 patient records included in the study, 28 (15.6%) developed SSI. The descriptive analysisrevealed that among the patients with SSI, 19 patients were men (67.9%), 18 (64.3%) had a low BMI, 8 (28.6%)had blood type A-, and 19 (67.9%) patients had a fever below 38 °C. Regarding clinical symptoms, 1 (3.6%)patient had gangrenous appendicitis, and 22 (78.6%) required urgent surgery. Notably, no significant riskfactors for SSI were identified. There was no association between SSI status and demographic variables,clinical symptoms, or underlying conditions (p>0.05).Conclusion: The incidence of SSI following appendectomy was relatively higher than in previous studies,though no significant risk factors were identified. Given this, standardization and adherence to evidence-basedinfection control practices, such as an appropriate preoperative antiseptic preparation, timely administrationof prophylactic antibiotics, and the use of laparoscopic techniques when feasible, might help reduce SSI risk.
Original Article
Fahimeh Feili; Mohammadali Roozegar; Aminollah Vasigh
Articles in Press, Accepted Manuscript, Available Online from 01 July 2025
Abstract
Objectives: This study aimed to determine the prevalence of dental trauma (DT) in pediatrics and adolescentsin Ilam.Methods: This retrospective study was conducted in Ilam (Iran) on a group of pediatric and adolescent patientswith DT between 2017 and 2021. The researchers reviewed patient records from ...
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Objectives: This study aimed to determine the prevalence of dental trauma (DT) in pediatrics and adolescentsin Ilam.Methods: This retrospective study was conducted in Ilam (Iran) on a group of pediatric and adolescent patientswith DT between 2017 and 2021. The researchers reviewed patient records from hospital-based specialty clinicsproviding DT treatment. Using a predefined checklist, they extracted the relevant data from the patients’medical files.Results: In this study, 246 pediatrics and adolescents were examined, including 144 (58.5%) boys and 102(41.5%) girls. Regarding age distribution, 104 (42.3%) patients were in the pediatric age group (mean age:7.1±3.2 years) and 142 (57.7%) were adolescents (14.8±5.1 years). A significant relationship was found betweenplace of occurrence with sex (OR=0.77; 95% CI=0.64-0.93; p=0.008) and age group (OR=0.73; 95% CI=0.6-0.89; p=0.002). Additionally, the type of trauma showed a significant association with sex (OR=1.24; 95%CI=1.08-1.43; p=0.002), while the treatment provided was significantly associated with school type (OR=0.79;95% CI=0.65-0.96; p=0.02). In addition, there was no significant relationship between the demographicvariables and dental injury-related factors (p>0.05).Conclusion: The present study found a higher prevalence of DT in boys than in girls. However, this trendreversed in the adolescent age group. In addition, public schools had a higher rate of DT, which influenced thetypes of treatments provided.
Original Article
Leila kouchakinejad-Eramsadati; Ali Asgary; Enayatollah Homaie Rad; Jon Mark Hirshon; Abbas Ostadtaghizadeh
Articles in Press, Accepted Manuscript, Available Online from 01 July 2025
Abstract
Objectives: This study aimed to explore experts’ perspectives on the factors influencing pedestrian trafficcollisions in Iran.Methods: This qualitative study was conducted using conventional content analysis with an inductive approachfrom September 2023 to March 2024. Twenty-six experts were purposefully ...
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Objectives: This study aimed to explore experts’ perspectives on the factors influencing pedestrian trafficcollisions in Iran.Methods: This qualitative study was conducted using conventional content analysis with an inductive approachfrom September 2023 to March 2024. Twenty-six experts were purposefully selected from across Iran. Datawere collected through individual face-to-face interviews, guided by a semi-structured interview, developedby a panel of experts and contained open-ended questions. Data analysis was performed manually using theGraneheim and Lundman approach (2004). To ensure trustworthiness, four strategies proposed by Lincoln andGuba were employed.Results: The results revealed two main categories: direct factors and underlying factors, comprising ninesubcategories. Direct factors included five subcategories: driver, pedestrian, roads and streets, vehicle, andgeographic factors. Underlying factors included four subcategories: governance factors, social determinants,cultural conditions, and economic status.Conclusion: The study identified key risk factors associated with pedestrian collisions according to experts’experiences. We recommend further qualitative studies to explore high-risk behaviors among pedestrians anddrivers in depth. Additionally, systematic reviews should examine strategies employed by developing andsuccessful countries to prevent or reduce pedestrian collisions.
Case Report
Bhavya Ganesh; Anil Kumar; Aadil Anees Abbas; Abdul Vakil Khan; Anurag Kumar; Majid Anwer; Sanjay Kumar; Rekha Kumari
Articles in Press, Accepted Manuscript, Available Online from 01 July 2025
Abstract
A 19-year-old male presented with a three-day history of worsening epigastric pain, persistent vomiting,abdominal distension, and obstipation. His medical history included high-fall trauma in 2022, resulting in aparietal bone fracture, scalp swelling, and an epidural hematoma. Physical examination revealed ...
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A 19-year-old male presented with a three-day history of worsening epigastric pain, persistent vomiting,abdominal distension, and obstipation. His medical history included high-fall trauma in 2022, resulting in aparietal bone fracture, scalp swelling, and an epidural hematoma. Physical examination revealed epigastrictenderness, abdominal distension, and diminished bowel sounds. Imaging revealed a 7 cm left diaphragmaticdefect with herniation of the stomach, colon, and mesentery into the thoracic cavity, confirming a diagnosis ofgastric volvulus with a diaphragmatic hernia. An exploratory laparotomy confirmed herniation of the stomach,transverse colon, spleen, and pancreas. The procedure involved derotation of the gastric volvulus, reductionof the herniated organs, and repair of the diaphragmatic tear; a fundoplication was also performed to preventrecurrence. The patient’s recovery was uneventful, and he was discharged on the fifth postoperative day. Heremained asymptomatic at the six-month follow-up. This case underscored the importance of consideringgastric volvulus and diaphragmatic hernia in trauma patients presenting with gastrointestinal symptoms,highlighting the necessity of early diagnosis and prompt surgical intervention.
Letter to the Editor
Mohammad Farhadi; Mohammadjavad Entezari
Articles in Press, Accepted Manuscript, Available Online from 01 July 2025
Abstract
Abstract I commend the authors for their insightful manuscript "Comparing the Performance of Emergency Department Personnel and Patients’ Preferences in Breaking Bad News."(1) This study examines a sensitive yet essential aspect of emergency care—effectively delivering bad news in high-stress ...
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Abstract I commend the authors for their insightful manuscript "Comparing the Performance of Emergency Department Personnel and Patients’ Preferences in Breaking Bad News."(1) This study examines a sensitive yet essential aspect of emergency care—effectively delivering bad news in high-stress environments. The findings highlight a notable discrepancy between emergency department (ED) personnel's communication practices and patients' expectations, underscoring the need for structured training and improved communication protocols in emergency medicine. The article provides valuable insights into the gap between ED personnel performance and patient preferences in BBN, supported by a solid methodological foundation. However, its impact is curtailed by limited generalizability, subjective performance measures, and a lack of nuanced interpretation or practical solutions. Future research should incorporate observer validation, and categorize bad news scenarios by severity. Time constraints in EDs should be quantified to explain performance gaps. A structured BBN protocol integrating patient preferences and cultural factors would enhance communication strategies. Addressing these weaknesses could elevate the study from a descriptive snapshot to a transformative contribution to emergency medicine communication practices.
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