[Fire work-related injuries in Tehran's Charshanbe Soori]

Fireworks are the leading cause of injuries in the ceremony of Chaharshanbeh Soori in Iran. The present study was designed to assess the prevalence and the severity of such injuries, the high-risk population, the causes and the accompanying morbidities in such ceremonies. This cross-sectional study was performed on individuals referred to different medical centers by Tehran Emergency Service due to fireworks- and Chaharshanbe soori-related injuries in 2007. The patients' demographic data, the cause of the accident, the type of the firework, the severity and the site of the injury, the performed prehospital and hospital care, and the patients condition at the time of discharge were extracted from the patients medical records. The information on the severity of the remaining morbidities in 8 months after the accident was also gathered. About 197 patients were enrolled in this study. The mean age of the patients was about 20.94 +/- 11.31 years. The majority of them were males. Crackers and home-made grenade were the most frequent cause of injury. The most frequently reported injuries consisted of bums, laceration and contusion, soft tissue injury and bone injuries, respectively. Fireworks should be produced and distributed based on standard regulations. Educating the families and students, and holding public ceremonies under the direct control of the families are considered as important strategies in reducing such injuries

[ efficacy of pre-hospital care in traumatic patients referred to emergency ward of "Sina Hospital" between September 2003 and September 2004]

The accuracy of the pre-hospital care has not been evaluated in Iran so that the purpose of the present study was to evaluate the efficacy of the pre-hospital care performed by Tehran Emergency Service in traumatic patients referred to "Sina Hospital". This prospective study was conducted on traumatic patients referred to emergency department of "Sina hospital" by Tehran Emergency Service from September 2003 to September 2004. The accuracy of the pre-hospital care performed by Tehran Emergency technicians, regarding the patients' general condition was evaluated. The on-call physicians in emergency department of "Sina hospital" were responsible for gathering the data and filling the questionnaires based on their observation and the EMS forms. 994 patients were enrolled in the study. Wound bandage and homeostasis were done correctly in 80% of the cases. Splint was applied correctly in 50% of the patients, while other therapeutic procedures such as collar and spinal bed were not performed among 80% of the cases. IV-line was obtained in 91.2% of the patients, while serum infusion was initiated in only 20% of patients. It is recommended to compile evidence-based protocols for the pre-hospital procedures and train the emergency technicians to follow the rules, in order to improve the efficacy and the accuracy of the pre-hospital care. According to the principal changes recently made in the quality and quantity of the care offered by Iran's Emergency Service, it is necessary to perform a new study to evaluate the present condition and compare the results of these, qualitative and quantitative changes with the current study

[Accuracy assessment of laparoscopic examination of intra-abdominal organs in trauma victims]

Performing traditional autopsy mostly seems to be unpleasant in dead persons' relatives' opinion. This study aimed to determine the accuracy of laparoscopic examination of intra abdominal organs in comparison to the traditional autopsy in trauma victims. From December 2004 to September 2005, 50 fresh cadavers of blunt trauma victims were studied in less than 24 hours from death time. Intraperitoneal and retroperitoneal organs were first evaluated by laparoscope and then the traditional autopsy was performed as gold standard. The organs were assessed regarding impairment and its grade in both ways. Diagnostic accuracy of laparoscope was determined for each case with 95% confidence interval using Fisher's exact test. The values of overall and distinct accuracy of laparoscopic examination for intraperitoneal and retroperitoneal organs were significantly comparable with traditional autopsy. The accuracy of laparoscopic evaluation of intraperitoneal and retroperitoneal organs were 90% [95% CI of 81.7% to 94.8%] and 92% [95% CI of 84.7% to 96%] respectively in comparison to open autopsy. The overall accuracy of laparoscopic examination was 84% [95% CI of 74.3% to 90.5%]. The sensitivity and specificity of laparoscopic examination for intraperitoneal but not retroperitoneal organs were acceptable in comparison to open autopsy. Laparoscopic examination seems to be an eligible substitute for the traditional autopsy in assessment of intraperitonel organs