Road traffic deaths in Kashan region, Iran: An eight-year study (2006-2013) / 中华创伤杂志(英文版)

<p><b>PURPOSE</b>The aim of this study was to analyze the trend of road traffic fatalities in Kashan Region, Iran, in a period of eight years.</p><p><b>METHODS</b>Through a cross-sectional study, all road traffic deaths classified under the V01V99 codes according to ICD-10 in Kashan region, central Iran, from March 2006 to March 2013 and population data were collected from the registration system of Kashan University of Medical Sciences. Years of lost life (YLL) and mortality rates were calculated regarding age, gender and year of the accident. Generalized linear model (GLM) with Poisson log-linear link was used to evaluate the effects of the mentioned variables on mortality rate.</p><p><b>RESULTS</b>During the period of the study (8 years), 928 people (767 men) died due to road traffic injuries (RTIs). The total YLL was 20,818. The mortality rate due to RTIs has been declined constantly from 43.1 in March 2006 to 21.1 per 100,000 in March 2013. The highest mortality rate was found in the age group of over 60 years old and the lowest in the age group of 0-14 years old. Both mortality rate and YLL was greater in men than in women. Poisson regression showed that age, gender and year of the accidents had a significant effect on mortality rate (p < 0.001).</p><p><b>CONCLUSION</b>Although there has been a constant decline of mortality rate in Kashan area within the study period, the value remains higher than the mean level of Eastern Mediterranean region and the global average, which is a notable fact for policymakers and authorities.</p>

Effects of pregabalin and gabapentin on postoperative pain and opioid consumption after laparoscopic cholecystectomy / 대한마취과학회지

BACKGROUND: Gabapentin and pregabalin are antiepileptic drugs that are also used for chronic pain treatment. This study evaluated the effects of pregabalin and gabapentin on postoperative pain in patients undergoing laparoscopic cholecystectomy. METHODS: A total of 108 candidates for elective laparoscopic cholecystectomy were randomly assigned to gabapentin (n = 36), pregabalin (n = 36), and placebo (n = 36) groups. Patients received 800 mg of gabapentin or 150 mg of pregabalin orally one hour before surgery. Postoperative analgesia was administered by pethidine via patient-controlled analgesia. The amount of opioid consumed, number of nausea events, vomiting, and pain scores at 2, 6, 12, and 24 hours after surgery were recorded. RESULTS: The gabapentin and pregabalin groups had significantly lower pain intensity than the placebo group, and pain intensity in the pregabalin group decreased more compared to the gabapentin group. The mean amount of pethidine consumption in the placebo group was significantly higher than in the gabapentin and pregabalin groups. CONCLUSIONS: A single dose of gabapentin or pregabalin decreased postoperative pain and nausea, as well as vomiting and opioid consumption after laparoscopic cholecystectomy. Moreover, the findings revealed that pregabalin was superior to gabapentin for reducing postoperative pain.

Status of ocular trauma in hospitalized patients in Kashan, 2011: As a sample of industrial city / 中华创伤杂志(英文版)

<p><b>PURPOSE</b>Ocular trauma is the third leading cause of hospitalization in ophthalmology patients, imposing direct and indirect physical and psychological costs on society. This study aims to investigate the status of ocular trauma in hospitalized patients in the industrialized city of Kashan in 2011.</p><p><b>METHODS</b>This cross-sectional descriptive applied study was conducted in 2012 on patients hospitalized for ocular trauma. Data, including age, gender, occupation, education, timing of admission following accident, location of accident, type of injury, damaging instrument, and type of trauma, were collected using a questionnaire designed by a trained nurse, and analyzed using SPSS-16 software by means of means ± standard deviation, frequency, and percentage for descriptive data and t-test, one-way analysis of variance, Chi-square and Fisher exact test for analysis at significance level of p < 0.05.</p><p><b>RESULTS</b>In total, 82 patients were hospitalized due to ocular traumas. The majority of patients were male (65 patients, 79.3%). Their mean age was (25.4 ± 21.4) years, with an age range of 20-40 years (30 patients, 36.6%). Hyphema was the most common injury (26 patients, 25.5%), home was the most frequent incident location (32 patients, 39%), and knife or other cutting tools were mostly responsible for injuries (18 patients, 21.9%). Patients were hospitalized for 1e6 days, and the average length of stay in hospital was 2.63 days. Frequency distribution of injuries based on whether or not ruptures differed significantly among different age groups.</p><p><b>CONCLUSION</b>The majority of ocular trauma occurred in young males. Knife was the principle culprit for eye injuries, followed by vehicles. To reduce such incidents, it is recommended that people be trained to avoid high-risk behaviors when using knives and to better heed driving rules and regulations.</p>

Cerebral state index versus Glasgow coma scale as a predictor for in-hospital mortality in brain-injured patients / 中华创伤杂志(英文版)

<p><b>OBJECTIVE</b>To compare the value of Glasgow coma scale (GCS) and cerebral state index (CSI) on predicting hospital discharge status of acute brain-injured patients.</p><p><b>METHODS</b>In 60 brain-injured patients who did not receive sedatives, GCS and CSI were measured daily during the first 10 days of hospitalization. The outcome of prognostic cut-off points was calculated by GCS and CSI using receiver operating characteristic (ROC) curve regarding the time of admission and third day of hospitalization. Sensitivity, specificity and other predictive values for both indices were calculated.</p><p><b>RESULTS</b>Of the 60 assessed patients, 14 patients had mild, 13 patients had moderate and 33 patients had severe injuries. During the course of the study, 17 patients (28.3%) deteriorated in their situation and died. The mean GCS and CSI in patients who deceased during hospitalization was significantly lower than those who were discharged from the hospital. GCS<4.5 and CSI<64.5 at the time of admission was associated with higher mortality risk in traumatic brain injury patients and GCS was more sensitive than CSI to predict in-hospital death in these patients. For the first day of hospitalization, the area under ROC curve was 0.947 for GCS and 0.732 for CSI.</p><p><b>CONCLUSION</b>GCS score at ICU admission is a good predictor of in-hospital mortality. GCS<4.5 and CSI<64.5 at the time of admission is associated with higher mortality risk in traumatic brain injury patients and GCS is more sensitive than CSI in predicting death in these patients.</p>

Pattern of ocular trauma among the elderly in Kashan, Iran / 中华创伤杂志(英文版)

<p><b>OBJECTIVE</b>Ocular trauma is a common cause of visual impairment and accounts for 38% to 52% of all patients presenting as ophthalmic accident and emergency cases to the hospital. The purpose of this study is to describe the pattern of ocular injuries that leads to hospitalization in the elderly in Kashan, Iran.</p><p><b>METHODS</b>In the retrospective consecutive case series, a total of 94 geriatric patients (larger than or equal to 65 years) who admitted and underwent management for ocular trauma from April 2001 to March 2011 at Matini Hospital of Kashan, the only center of eye surgery in the region of Kashan, were reviewed. The items include age, sex, injury mechanism, site and extent of damage, presenting and final best corrected visual acuity at least 3 months after trauma, which were reviewed and analyzed with SPSS software.</p><p><b>RESULTS</b>During the 10 years, 94 eyes of 94 patients with ocular trauma were included. Mean age of patients was (77.5+/-5.1) years (range 65 to 102 years). Male to female ratio was 2.76. The mechanism of ocular injury included sharp trauma in 56 patients (59.6%) and blunt in 38 patients (40.4%). Trauma occurred mostly in males (69 patients, 73.4%) and at the work place (38 patients, 40.4%). On admission the visual acuity in 50 patients (53.2%) with damaged eyes was light perception to hand motion. While the final best corrected visual acuity in 36 patients (38.3%) was better than hand motion.</p><p><b>CONCLUSION</b>Ocular trauma is a serious cause of visual impairment in the elderly. Appropriate and timely management may improve their visual prognosis.</p>

Pattern of pediatric ocular trauma in Kashan

Ocular trauma is a significant health problem in pediatric patients. The aim of this study was to analyze the characteristics of ocular-traumarelated hospitalization of children in Kashan. This descriptive, cross-sectional study included 131 children aged less than 16 years with ocular trauma, who were admitted to the Matini Hospital at the Kashan University of Medical Sciences between April 2006 and March 2009. After admission,detailed ocular examination was performed, and their ocular trauma was classified according to the International Ocular Trauma Classification and Birmingham Eye Trauma Terminology systems. Mean age of the patients was 7.8 +/- 2.2 years [age range, 0-16 years], and male to female ratio 5:1. The most common cause of admission was hyphema [38.1%], followed by corneoscleral laceration [27.5%]. Ocular trauma most commonly occurred at home [43%], and 69% of the patients presented to the emergency room within 24 h of injury. In 30% of the patients, initial visual acuity at the time of presentation was less than 20/200 [Figure 1]. Ocular trauma is a major cause of unilateral blindness, especially in young boys, and hence, preventive measures and education is required