Prognosis in children with traumatic injuries referring to the emergency department / 中华创伤杂志(英文版)

Purpose:@#Trauma may lead to serious complications in children patients. The purpose of this study was to investigate prognosis in children with traumatic injuries.@*Methods:@#This cross-sectional study was conducted on all of the children (<18 years old) who had suffered traumatic injuries and transferred to the emergency department of Imam Hussein Hospital by emergency medical services. After selecting the children, a checklist including information such as demographic characteristics, trauma type, consciousness level, and final outcome was recorded. Finally, the data were analyzed using t-test, Chi-square test and ANOVA.@*Results:@#In total of 564 children were investigated. Among them, 70% were males, and 33.2% were in the age range of 5-12 years. The mechanism of injuries in 97.9% of the cases was blunt trauma. The most common chief complaint among the affected children was nausea. The majority of them had stable vital signs and normal neurological tests results. However, 1.06% of them died during hospitalization. The results indicated that the final outcome in the children affected by traumatic injuries is significantly related to the type of trauma, the location of traumatic event, the vehicle used to transport them to emergency departments and their Glasgow coma scale score (p < 0.05).@*Conclusion:@#Considering the young age of the child patients and over half of trauma happened at home, it is important to raise parents' awareness about the risky places and activities, which were likely to result in traumatic injuries for children.

The Effects of Air Pollution on Ischemic Stroke Admission Rate / 전남의대학술지

The present study aimed to determine the relationship between the level of air pollutants and the rate of ischemic stroke (IS) admissions to hospitals. In this retrospective cross-sectional study, stroke admissions (January-March 2012 and 2013) to an emergency department and air pollution and meteorological data were gathered. The relationship between air pollutant levels and hospital admission rates were evaluated using the generalize additive model. In all 379 patients with IS were referred to the hospital (52.5% male; mean age 68.2+/-13.3 years). Both transient (p<0.001) and long-term (p<0.001) rises in CO level increases the risk of IS. Increased weekly (p<0.001) and monthly (p<0.001) average O3 levels amplifies this risk, while a transient increase in NO2 (p<0.001) and SO2 (p<0.001) levels has the same effect. Long-term changes in PM(10) (p<0.001) and PM(2.5) (p<0.001) also increase the risk of IS. The findings showed that the level of air pollutants directly correlates with the number of stroke admissions to the emergency department.

The Effects of Air Pollution on Ischemic Stroke Admission Rate / 전남의대학술지

The present study aimed to determine the relationship between the level of air pollutants and the rate of ischemic stroke (IS) admissions to hospitals. In this retrospective cross-sectional study, stroke admissions (January-March 2012 and 2013) to an emergency department and air pollution and meteorological data were gathered. The relationship between air pollutant levels and hospital admission rates were evaluated using the generalize additive model. In all 379 patients with IS were referred to the hospital (52.5% male; mean age 68.2+/-13.3 years). Both transient (p<0.001) and long-term (p<0.001) rises in CO level increases the risk of IS. Increased weekly (p<0.001) and monthly (p<0.001) average O3 levels amplifies this risk, while a transient increase in NO2 (p<0.001) and SO2 (p<0.001) levels has the same effect. Long-term changes in PM(10) (p<0.001) and PM(2.5) (p<0.001) also increase the risk of IS. The findings showed that the level of air pollutants directly correlates with the number of stroke admissions to the emergency department.

effect of emergency department overcrowding on efficiency of emergency medicine residents' education

Creating a calm and stress-free environment affects education significantly. The effects of the emergency department overcrowding [EDO] on the training of emergency medicine residents [EMR] is a highly debated subject. Therefore, this study aimed to evaluate the effect of EDO on efficiency of EMR's education. In this cross-sectional study, the effects of overcrowding on EMR's education in the resuscitation room and acute care unit. Data collection was done using a questionnaire, which was filled out by the second year EMRs. The crowding level was calculated based on the national emergency department overcrowding scale [NEDOCS]. The relationship between the two studied variables was evaluated using independent sample t-test and SPSS 21 statistical software. 130 questionnaires were filled out during 61 shifts. 47 [77.05%] shifts were overcrowded. The attend's ability to teach was not affected by overcrowding in the resuscitation room [p=0.008]. The similar results were seen regarding the attend's training ability in the acute care unit. It seems that the emergency department overcrowding has no effect on the quality of education to the EMRs

Nasoalveolar molding in cleft lip and palate, a review of literature

Nasoalveolar molding represents a paradigm shift from traditional presurgical orthopedics in the care of cleft lip and palate patients which has been applied increasingly in the past two decades. This article is a review of recent literature apropos of objectives, appliances, complications and short and long term effects of this technique

Knowledge of emergency medicine residents in relation to prevention of tetanus

Knowledge of emergency medicine residents about the management of patients suspected of having tetanus-favoring wounds is very important due to their responsibility for the treatment of such patients. The aim of the present study was to evaluate this knowledge and making sure of the adequacy of instructions they have received in relation to prevention of tetanus. A reliable and reproducible questionnaire was used to evaluate knowledge of all the emergency medicine residents in Imam Hussein Hospital in Tehran, Iran, about conditions favoring tetanus [9 questions] and proper interventions in such conditions [12 questions]. The questionnaires were completed and scored as poor and good. The Mann-Whitney U test was used to analyze data. Statistical significance was set at P<0.05. In the present study, 73 emergency medicine residents were evaluated [45.2% male]. Knowledge of 31 [42.5%] residents in relation to conditions favoring tetanus and 41 [56.2%] residents in correct therapeutic interventions was in good level. The most frequent incorrect answer was related to diabetic ulcers and wounds in patients with sepsis. There was an increase in scores of conditions favoring tetanus [P<0.001] and correct therapeutic interventions [P=0.001] with an increase in educational years. However, age [P=0.64], gender [P=0.31], job experience [P=0.38] and participation in educational courses [P=0.67] had no effect on the knowledge level of emergency medicine residents. According to the findings of the pre-sent study, the knowledge of emergency medicine residents about correct management of patients suspected of tetanus was low, which emphasizes the necessity of providing further instructions on prevention of tetanus in wound management

Substance abuse among drivers of motor vehicle collisions

Motor vehicle collisions [MVC] comprise a majority cause of referral to the emergency department [ED]. A large proportion of MVC appear to be preventable, if more effective measures against driving after substance abuse can be implemented. This study was aimed to investigate the prevalence of substance abuse among drivers of MVC, following road traffic accidents [RTA]. This case-control research was conducted from July to October 2007. One hundred MVC drivers admitted in the ED were included as the case group and 110 hospitalized patients, due to nontraumatic causes were used as controls. History of substances abused was obtained and urine samples were tested for opium in both groups. Finally the history and laboratory results of the groups were compared using SPSS 18. Of the 100 patients in the case group, 39 [39%] were positive for substance abuse [100% male] On the other hand, 49 [44.5%] patients in the control group had positive history or laboratory findings of substance abuse [73.9% male]. Opioids were the most common agent abused in both groups. There was no significant difference between two groups regarding the prevalence of substance abuse [P = 0.92]. The prevalence of substance abuse is high among victims of road traffic injury but in equal proportion to the control group. Health education and counseling is needed to reduce substance abuse in the general population although it was not significantly related to the cause of RTA