[Causes of mortality in patients referred to emergency unit of Tabriz Imam Reza hospital, in 2014-2015]

Background: Being the first-line treatment of patients, emergency units have an especial importance. The mortality of patients in the emergency department is a problem that has been exacerbated in recent years. Further studies on the causes of death are required in the emergency for correct judgment. This study is conducted in order to better understand the causes of death, in patients referred to emergency unit of Tabriz Imam Reza hospital in 2014 - 2015

Methods: This cross-sectional study was carried out on the profiles of all patients admitted to the emergency department of Tabriz Imam Reza hospital. Demographic data and causes of death were extracted

Results: Of the 604 patients who died in the emergency department, 60.6% were men, 54.6% derrram and 31.5% had over 75 years. The most common causes of death were internal illnesses [22.2%] and trauma [19%]. In total, 39.1% patients were died before in the emergency department and 32.1% of patients were referred from anther hospitals

Conclusion: It seems that internal illnesses and trauma are the most common causes of death in the emergency department. The high rate of mortality shows the importance of early aids and proper referral system

Poisonous spiders: bites, symptoms, and treatment; an educational review

More than 40,000 species of spiders have been identified in the world. Spider bites is a common problem among people, however few of them are harmful but delay in treatment can cause death. Since the spider bites are risk full to human, they should be taken seriously, especially in endemic areas. Our objective in this review was to study about poisonous spiders and find out treatments of them. Therefore, we collected related articles from PubMed database and Google Scholar. Three important syndromes caused by spider bites are loxoscelism, latrodectism and funnel web spider syndrome. Many treatments are used but much more studies should have done to decrease the mortality. In this review, we describes different venomous spiders according to their appearance, symptoms after their bites and available treatments

Thoracic pneumorrhachis in patient with lumbar fractures; a case report

Pneumorrhachis as a relatively rare condition may be an indication of substantial intra-spinal column injury. Here we report a 39-year-old man was admitted because of low back pain and dyspenea after locating between motor vehicle and wall three days before admission. On arrival, physical exams and vital signs were normal. Computed tomography [CT] scan showed bilateral pleural effusion, fracture of ribs number 8, 9 and 10 in lower left side of thorax, fracture of vertebra in L2-L4, and air bubbles in upper thoracic spinal canal

Transient unexplained shock in 30-year-old trauma patient

Shock as an inadequate tissue perfusion is one of the frequent causes of death in trauma patients. In this context, there are various reasons for hemodynamic instability and shock including hypovolemic [hemorrhagic], obstructive [cardiac tamponade, tension pneumothorax], cardiogenic, neurogenic, and rarely septic. In the present report, a 30-year-old trauma patient with full clinical signs and symptoms of shock referred while had unknown origin; it was finally recognized as anaphylactic shock

Sensitivity of palm print, modified mallampati score and 3-3-2 rule in prediction of difficult intubation

This study evaluated the performance of modified Mallampati score, 3-3-2 rule and palm print in prediction of difficult intubation. In a prospective descriptive study, data from 500 patients scheduled for elective surgery under general anesthesia were collected. An anesthesiologist evaluated the airway using mentioned tests and another anesthesiologist evaluated difficult intubation. Laryngoscopic views were determined by Cormack and Lehane score. Grades 3 and 4 were defined as difficult intubation. Sensitivity, specificity, positive predictive value, negative predictive value and Youden index were determined for all tests. Difficult intubation was reported in 8.9% of the patients. There was a significant correlation between body mass index and difficult intubation [P: 0.004]; however, other demographic characteristics didn't have a significant correlation with difficult intubation. Among three tests, palm print was of highest specificity [96.46%] and modified Mallampati of highest sensitivity [98.40%]. In a combination of the tests, the highest specificity, sensitivity and Youden index were observed when using all three tests together. Palm print has a high specificity for prediction of difficult intubation, but the best way for prediction of difficult intubation is using all three tests together