Elastofibroma of the face: a case report

Elastofibroma is a rare neoplasm that characteristically occurs in subscapular area in response to microtrauma. There are some reports of this tumor in other sites of the body but, up till now, there has been no report of elastofibroma in the face. A 20-year-old man presented with a slow growing painless mass in the face without any history of trauma. Histopathologic examination revealed a soft tissue mass composed of eosinophilic fibers admixed with aggregation of fat cells, capillary blood vessels, and fibroblasts. Elastic stain and Masson's trichrome stain confirmed the nature of elastic and collagen fibers. It was a case of elastofibroma in the face

Spinal cord injury in Parkour sport (free running): a rare case report / 中华创伤杂志(英文版)

A 24-year-old male was transferred to the emergency department while being in the state of quadriplegia with a history of performing Parkour sport, which is also called double front flip. Neurological examination revealed that the patient's muscle power was 0/5 at all extremities. The patient did not show any sense of light touch or pain in his extremities. In radiological studies, cervical spine X-ray and CT scan images showed C4-C5 subluxation with bilateral locked facets and spinal cord injury. The results of this very rare case study revealed that exercising Parkour sport without taking into account safety standards could result in irreversible injuries to the cervical spinal cord with fatal outcome.

Effect of follicular fluid and platelet-activating factor on lactate dehydrogenase C expression in human asthenozoospermic samples

Background: Application of follicular fluid [FF] and plateletactivating factor [PAF] in artificial insemination improves sperm motility. Lactate dehydrogenase C [LDH-C] is a key enzyme for sperm motility. In this study, the effects of FF and PAF on the sperm motility index and LDH-C expression were investigated. Moreover, LDH-C expression was compared between asthenozoospermic and normozoospermic samples

Methods: The expression of LDH-C was examined by quantitative real-time polymerase chain reaction [q-RT PCR] and western blotting after it was treated with optimized concentrations of FF and PAF in twenty asthenozoospermic samples. Also, LDH-C expression was evaluated in five normozoospermic samples

Results: Samples with 75% FF and 100 nM of PAF had an increase in their percentages of progressive and slowly motile sperms and a decrease in their percentages of non-progressive and non-motile sperms. Moreover, LDH-C mRNA transcripts were not changed following PAF and FF treatment, and LDH-C protein was detected in highly progressive motile specimens treated with FF in the asthenozoospermic samples. Furthermore, LDH-C expression was more detectable in the normal sperms

Conclusion: Our results indicated that PAF had more beneficial effects than FF on sperm motility in the asthenozoospermic samples [P=0.0001], although the LDH-C expressions of the sperms were not changed significantly in both groups. We found no association between LDH-C expression and sperm motility after FF and PAF actions. This finding, however, requires further investigation. The fact that LDH-C protein was detected in the normozoospermic, but not asthenozoospermic, samples could be cited as a reason for the infertility in these patients

Simultaneous spectrophotometric determination of tramadol and acetaminophen in pharmaceutical formulationsusing H-point standard addition method

H-point standard addition method [HPSAM] was applied to the simultaneous spectrophotometric determination of tramadol and acetaminophen in pharmaceutical formulations. The results showed that tramadol and acetaminophen can be determined simultaneously in the range 5.0-100 and 1.0-10 microg/ml, respectively. The limits of detection [LOD] for tramadol and acetaminophen were obtained 2.0 and 0.50 microg/ml, respectively. Relative standard deviation for five replicate simultaneous determinations of tramadol and acetaminophen were calculated to be 3.2 and 3.3%, respectively. The proposed method has been successfully applied to the simultaneous determination of tramadol and acetaminophen in some synthetic, pharmaceutical formulation

Modern concepts of transport in multiple trauma: a narrative review / 中华创伤杂志(英文版)

Multiple variables can influence triage decision in multiple trauma. Recognition of priorities and selection of the destination can be successfully achieved by field triage and individualized clinical judgment. This narrative review summarizes the new options and protocols for transport of injured subjects. There are four levels of emergency medical providers including first responders and three levels of emergency medical technicians. Two distinct accepted protocols for transport are known as scoop and run and treat and then transfer. The former provides minimum lifesaving treatment at the scene of accident followed by transferring the patient(s) as soon as possible, and the latter mainly emphasizes the need for complete stabilization as a prerequisite for safe transport. The destination and mode of transport are selected according to clinical capabilities of the receiving hospital, transfer time from the scene to the facility, patient's medical condition, accessibility of the scene, and weather. Two common methods of transfer are ground transport, including various type of ambulances, and air medical transport, i.e. helicopter and airplane.

Office-based slit-lamp needle revision with adjunctive Mitomycin-C for late failed or encapsulated filtering blebs

The purpose of this study was to assess the results of bleb needling in glaucomatous patients with late failed filtering blebs. A retrospective case series of 27 eyes of 27 patients was considered. All patients underwent needle bleb revision with adjuvant mitomycin-C performed at the slit lamp, during an office visit. Complete success was defined as postneedling intraocular pressure [IOP]=21 mmHg without any antiglaucoma medications and qualified success was IOP=21 mmHg with topical antiglaucoma medications. There were 12 eyes with encapsulated blebs and 15 eyes with flat blebs. The mean interval between index filtering surgery and bleb revision was 32.74 +/- 15.36 months. Mean IOP was 25.07 +/- 4.80 mmHg before surgery and 19.66 +/- 4.97 mmHg at last postoperative follow-up. The mean follow-up was 20.31 +/- 15.63 months. Complete and qualified successes were 7.4% and 51.9%, respectively. Cumulative rates of success at 1, 2, 3, and 4 years were 76%, 65%, 49%, and 37%, respectively. The mean number of antiglaucoma medications was reduced from 3.15 +/- 0.36 preoperatively to 2.33 +/- 1.21 postoperatively [P<0.001]. Slit-lamp needle revision in office is a simple and effective method for treating late encapsulated or flat filtering blebs without significant complications even for late bleb failure

Evaluation of effects of Zingiber officinale on salivation in rats

There are some herbal plants in Iranian traditional system of medicine which are believed to be excellent remedies to alleviate the symptoms of xerostomia. The aim of the present study was to evaluate the effect of systemic administration of seven different herbal extracts on the rate of salivation in rats. The extracts of 7 herbs; Zingiber officinale Roscoe [Zingiberaceae], Citrus sinensis [L.] Osbeck [Rutaceae], Artemisia absinthium L. [Asteraceae], Cichorium intybus L. [Asteraceae], Pimpinella anisum L.[Apiaceae], Portulaca oleracea L.[Portulacaceae], Tribulus terrestris L. [Zygophyllaceae] were prepared. Nine groups of animals [including negative and positive control groups] were used and seven rats were tested in each group. After the injection of extracts, saliva volume was measured gravimetrically in four continuous sevenminute intervals. The results showed that after injection of ginger extracts salivation was significantly higher as compared to the negative control group and other herbal extracts in all of the four intervals [P<0.01]. The peak action of the ginger was during the first 7-minute interval and following this, salivation decreased to some extent. The present study suggests that the extract of Zingiber offiicianle can increase the rate of salivation significantly in animal model. Further investigations on different constituents of ginger seem to be essential to identify the responsible constituent for stimulation of saliva secretion

[In vitro Comparison of antimicrobial activity and cytotoxic effects of Listerine and Irsha mouthwashes]

Irsha is an Iranian sample of Listerine mouthwash. To date biologic effects of Irsha and Listerine have not been compared. This study compared the antimicrobial and cytotoxic effects of Listerine and Irsha mouthwashes. In this in vitro study, antimicrobial effects of 5 dilutions of Irsha and Listerine, on the 0.5 MacFarlnd concentrations of five bacterial strains [Streptococcus mutans, Streptococcus Sangius, Enterococcus Fecalis, Candida albicans and Escherichia coli] were assessed at different times. Each test was repeated three times, with distilled water as control. For cytotoxic effect, more than 100000 cells of KB [epithelial cell], J774.A1[macrophage], Saos-2 [osteoblast] and MRF [fibroblast] were cultured and incubated for 72 hours in different dilutions of the two mouthwashes [0.5, 1, 5, 10%]. After incubation, the cells were washed and stained with MTT for 45 minutes. The results were recorded with ELISA READER and analyzed with SPSS 18 software, using ANOVA, Tukey test and one-way ANOVA. Statistical significance was defined at p value < 0.05. The cytotoxic effects of various dilutions of Listerine and Irsha mouthwashes were not significantly different [p value > 0.05]. In terms of antimicrobial activity, in dilutions of 100% and 50% of Listerine none of the five bacterial strains grew. However, at the same dilutions [100% and 50%] of Irsha, only three strains did not grow. According to the results, antimicrobial activity of Listerine is probably better than Irsha, but cytotoxic effects of Listerine and Irsha mouthwashes were not different

Trauma care system in Iran / 中华创伤杂志(英文版)

<p><b>OBJECTIVE</b>The high burden of injuries in Iran necessitates the establishment of a comprehensive trauma care system. The purpose of this paper is to describe the current status of trauma system regarding the components and function.</p><p><b>METHODS</b>The current status of trauma system in all components of a trauma system was described through expert panels and semi-structured interviews with trauma specialists and policy makers.</p><p><b>RESULTS</b>Currently, various organizations are involved in prevention, management and rehabilitation of injuries, but an integrative system approach to trauma is rather deficient. There has been ongoing progress in areas of public education through media, traffic regulation reinforcement, hospital care and prehospital services. Meanwhile, there are gaps regarding financing, legislations and education of high risk groups. The issues on education and training standards of the front line medical team and continuing education and evaluation are yet to be addressed. Trauma registry has been piloted in some provinces, but as it needs the well-developed infrastructure (regarding staff, maintenance, financial resources), it is not yet established in our system of trauma care.</p><p><b>CONCLUSIONS</b>It seems that one of the problems with trauma care in Iran is lack of coordination among trauma system organizations. Although the clinical management of trauma patients has improved in our country in the recent decade, decreasing the burden of injuries necessitates an organized approach to prevention and management of trauma in the context of a trauma system.</p>

Spinal fractures resulting from traumatic injuries / 中华创伤杂志(英文版)

<p><b>OBJECTIVE</b>To illustrate mechanisms of spine fractures and the pattern of spinal injuries characterized by the major mechanisms in urban population of Iran.</p><p><b>METHODS</b>Data regarding spinal injuries including demographics, mechanism and level of spinal injury, abbreviated injury score, associated injuries and final fate of the patients were extracted from the Iranian national trauma registry database from 1999 to 2004.</p><p><b>RESULTS</b>A total of 619 patients with traumatic spine fractures were identified, of whom 68.5% were males. The peak frequency of these injuries occurred in the 21-40 year age-group. Accidental falls and road traffic crashes (RTCs) were the most common mechanisms of spinal fractures (47.2% and 44.1%, respectively). RTCs tended to occur in younger patients compared with accidental falls. The most common spinal region for spinal fracture was the lumbar spine (53.63%). Cervical spine fractures were significantly more common in RTCs, while lumbar spine fractures were more common in accidental falls (P less than 0.001). A total of 171 (27.6%) patients had associated non-spinal injuries, of whom 127 had associated extremity injuries, and 55 had head injuries. Thirty-six (5.6%) patients had spinal cord injury (SCI).The injury severity score of the RTC group was significantly higher than that of accidental falls (P equal to 0.002). Fifteen (4%) patients died of traumatic injuries. The rate of death was significantly higher in RTCs compared with accidental falls (5.1% vs 2.1%, P equal to 0.039).</p><p><b>CONCLUSIONS</b>The patterns of spinal fractures are similar to those reported from developed countries. RTCs tend to affect the younger age population and are associated with a higher degree of associated injuries and mortality than accidental falls. Therefore preventive strategies should be based on reduction of the number and severity of RTCs.</p>

Prevalence of calibration errors in Goldman applanation tonometers

To determine the prevalence of calibration errors in Goldmann applanation tonometers at Farabi Eye Hospital. This cross-sectional study was performed on all tonometers in use at Farabi Eye Hospital. All Haag-Streit Goldmann applanation tonometers were checked according to the manufacturer's method by two independent observers and by a third observer in case of mismatched results. Calibration errors were classified into 6 categories of +/- 0.5, +/- 1, +/- 1.5, +/- 2, +/- 2.5 and more than +/- 2.5 mmHg. Overall, 43 Goldmann tonometers were evaluated. There were 3 [7%], 10 [24.3%], 16 [38.3%], 24 [56.9%], 31 [72.1%] and 12 [27.9%] tonometers within calibration errors of +/- 0.5, +/- 1, +/- 1.5, +/- 2, +/- 2.5 and more than +/- 2.5 mmHg respectively. Goldmann tonometers were not within the manufacturer's recommended range [ +/- 0.5 mmHg] in 93%, and not within the acceptable range of +/- 2.5 mmHg in 28% of checked devices. Further study is needed to demonstrate the correlation between calibration errors and clinical errors

Comparison of road traffic fatalities and injuries in Iran with other countries / 中华创伤杂志(英文版)

<p><b>OBJECTIVE</b>To compare fatalities and injuries in road traffic crashes (RTC) in Iran with other countries.</p><p><b>METHODS</b>Data were obtained from national health sources of Iran. These data included population number, registered motor-vehicles number, number of RTCs and consequent fatalities and injuries from 1997 to 2006.</p><p><b>RESULTS</b>RTC fatality and injury rates increased from 1997 to 2005, but decreased in 2006. The overall men/women ratio in the RTC fatalities was 4.2:1. High RTC fatality rate of 39 per 100 000 population in Iran was almost the same as some other developing countries. In Iran, RTC fatalities in recent years were almost twice as much as the highest rate among the European countries.</p><p><b>CONCLUSIONS</b>This investigation shows that in spite of reduction of RTC fatality in Iran in 2006, it is still one of the highest in the world. Moreover, this paper describes the state of RTC-related parameters in a developing country in comparison with the developed countries.</p>

[Drug abuse in hospitalized trauma patients in a university trauma care center: an explorative study]

Drug abuse has been known as a growing contributing factor to all types of trauma in the world. The goal of this article is to provide insight into demographic and substance use factors associated with trauma and to determine the prevalence of drug abuse in trauma patients. Evidence of substance abuse was assessed in trauma patients presenting to Sina trauma hospital over a 3-month period. They were interviewed and provided urine samples to detect the presence of drug/metabolites of opium, morphine, cannabis and heroin by 'Morphine Check' kits. Demographic data, mechanisms of injury, history of smoking and drug abuse were recorded. A total of 358 patients with a mean age of 28.4 years were studied. The Patients were predominantly male [94.7%]. There was a history of smoking in 136 cases [38%]. 58 cases [16.2%] reported to abuse drugs [91.5% opium]. The commonest route of administration was smoke inhalation [37.2%]. Screening by Morphine Check test revealed 95 samples to be positive [26.5%]. The preponderance of test-positive cases was among young people [of 20-30 years of age] with a history of smoking. Victims of violence and those with penetrating injuries also showed a higher percentage of positive screens [P=0.038 and P<0.001, respectively]. These results suggest that drug abuse is a contributing factor to trauma especially in violent injuries and among the young. Regarding the considerable prevalence of drug abuse among trauma patients, it's highly recommended that all trauma patients be screened for illicit drugs