Pattern of animal-related injuries in Iran

Animal related injuries as most common causes of human morbidity have different pattern by geographical zones. We aimed to explore the main descriptive epidemiology of animal-related injuries in both rural and urban areas in Iran. Between 2000 and 2004, we collected the data of all the cases of animal related trauma hospitalized for more than 24 hours in eight cities [Tehran, Mashhad, Ahwaz, Shiraz, Tabriz, Qom, Kermanshah, and Babol]. Further evaluations were conducted on 17753 eligible subjects. Of 17753 traumatic patients, 40 subjects [0.2%], had animal-related injuries. The highest rate was seen in Tabriz with 11 cases. Upper and lower extremities were the most frequent sites of trauma and they were injured in 13 and 11 cases respectively. Dog bite and cow-related injuries were responsible for 40% and 32.5% of injuries respectively. Amputation of the phalanx was done in 2 cases due to dog bite and bull gore occurred. One thoracotomy, one laparatomy and one craniotomy were done. One patient needed fasciatomy due to snake bite. Educating the patients could decrease the incidence of morbidity of these injuries

Patterns of extremity traumas leading to amputation in Iran: results of Iranian National Trauma Project / 中华创伤杂志(英文版)

<p><b>OBJECTIVE</b>To determine the patterns of traumatic extremity injuries leading to amputation in Iran.</p><p><b>METHODS</b>Data of Iranian National Trauma Project was used to identify patients with upper and lower extremity traumas undergoing amputation. This project was conducted in 8 major cities during 2000-2004.</p><p><b>RESULTS</b>Of 17 753 traumatic patients, 164 (0.92%) had injuries to the extremities that resulted in the limb amputation. Of these, 143 (87.2%) were men. The patient's mean age was 29.0 years +/- 15.4 years and the highest incidence was seen in the age group of 21 to 30 years (34.1%). One hundred and four cases were occupational accidents (63.4%). Blunt trauma was in 54.9% of the cases. The most common reasons for amputation were respectively stabbings (37.8%) and crush injuries (31.7%). Amputation of hand fingers was the most frequent type of amputation (125 cases, 76.2 %). One patient died from severe associated injuries.</p><p><b>CONCLUSIONS</b>This study shows the patterns of traumatic limb amputation in Iran, a developing country. Results of this study may be used in preventive strategic planning.</p>

Creation of permanent hemodialysis vascular access in patients with failed arteriovenous fistula

To compare the patency rate and complications of arteriovenous fistula [AVF] with synthetic graft in patients with previous history of failed AVF. This study was carried out at Sina Hospital, Tehran, Iran from April 2002 to July 2003. Patients who had been referred to our center with previous failed attempt for creation of AVF were collected. We again tried to create an AVF in some of these patients according to physical examination and clinical judgment of the vascular surgeon. A synthetic graft was inserted for the remainder of the patients. All patients were followed up for 3 months. Elbow fistula placement was possible in 43% of patients including half of patients with diabetes and half of those more than 65 years old. Failure occurred in 33% of grafts versus 19% of fistulas. The complications were venous hypertension in one case and infection in 2 cases, all from the graft group. Our results show lower failure, mortality, and complication in AVFs than the synthetic graft, similar to previous reports. However, there were some limitations such as small sample of patients and short duration of follow up in our study. We suggest that AVF is an option even in patients who had previous multiple procedures with the advantage of being cost-effective, and with fewer complications. However, we cannot conclude any superiority for one method, as it is not a properly designed comparative trial