ABSTRACT
Main goal in the management of patients with severe traumatic brain injury [TBI] is control of intracranial pressure [ICP]. Decompressive craniectomy is an accepted technique for control of refractory intracranial hypertension in patients with severe TBI. Because of high complication rate after decompressive craniectomy, new techniques such as basal cisternostomy have developed. We herein report a case of severe TBI in a 13-year-old boy treated by cisternostomy. The patient was admitted following a motor vehicle accident. Brain CT scan showed diffuse brain edema, left frontal contusion and posterior interhemispheric subdural hematoma. The patient underwent ICP monitoring. Subsequently, with 26 mmHg mean-value of ICP, he was treated surgically by cisternostomy technique. A progressive improvement of the neurological conditions in the following hours. After 5 days the boy was discharged and in the 3-months follow-up he was completely recovered. Cisternostomy could be an appropriate alternative to decompressive craniectomy for management of intracranial hypertension in patietns with sever TBI
ABSTRACT
Tea is the most popular nonalcoholic beverage worldwide. In recent years, some Iranian studies have shown the occurrence of toxic elements in fresh or dried tealeaves as well as in brewed tea. The present study aimed to ascertain the health risks associated with exposure to toxic and essential element through black tea consumption in Iran by systematically reviewing the accredited articles in the field. In order to obtain the relevant articles and academic databases, the search engines covering the specifi c disciplines were searched for the keywords, including tea, elements, heavy metals and determination. Having provided the complete list of sound articles, being conducted in Iran was considered as the inclusion criteria. Exclusion criteria were established as failure to provide information on the validity parameters and accuracy in the analytical methods. Choosing well conducted, reliable studies, analytical results for the concentration of each element in black tea were utilized in the determination of the hazard quotient [HQ] for the given element and the hazard index [HI] was then determined for all of the elements in each study. Among the total studies, two were considered to be reliable. Aluminum was found to be the most abundant element in black tea marketed in Iran. Although the HQ for manganese was the highest among the studied elements, HQ and HI values for both toxic elements and essential elements were calculated as less than 1. The hazard of excessive element intake through black tea consumption should be considered as negligible in Iran. However, related risk for manganese appeared to be more than toxic metals