[QTc interval changes in patients with moderate to severe brain injury]

Brain trauma is one of the most important causes of morbidity and mortality, especially in the urban and industrial societies. Risk factors that increase the mortality of the patients are aging, other organs trauma and cardiac arrhythmia. Some of the ECG abnormalities following traumatic brain Injury are tachy-arrhythmia, brady-arrhythmia, increased QTc interval and changes in ST segment. Traumatic brain patients also show subarachnoid hemorrhage [SAH] and increased QTc intervals. Our aim in this study is to evaluate QTc interval changes in patients with moderate to severe brain injury. This retrospective study was performed on 200 patients with moderate to severe head injury, who were admitted in Al-Zahra and Kashani hospitals, in Isfahan city, Iran between years 2004-2006. QTc interval [based on Bazett formula] and level of consciousness [based on Glasgow coma scale] were obtained from the patients' files. Data were analyzed using student t-test and Chi-square test. The most common injury in the patients was intracranial hemorrhage [ICH]. Our study did not show any correlation between age and level of consciousness with QTc interval [P>0.05]. The most common cause of mortality in our patients was subarachnoid hemorrhage [SAH]. There was no significant correlation between causes of injury and patient's mortality [P>0.05]. Evaluating QTc intervals from the files of the patients who were died showed that they had longer QTc interval compared to the alive patients' [P<0.01]. QTc interval was longer in women compared to men [P<0.05]. A direct correlation was seen between decreased level of consciousness and QTc interval elongation [P<0.001]. Our findings show that QTc interval can be used as a good index for mortality in the patients with moderate to severe brain injury. QTc interval prolongation has correlation with severity of consciousness loss and mortality

[Evaluation of scoliosis screening results in 10-14 years old students of Shahrekord]

Scoliosis is referred to abnormal curvature of spinal column beyond 10 degrees. The most common type of it, is adolescent idiopathic scoliosis. Scoliosis screening test is the most economic and simplest method for diagnosis of the disease. Preferred age of scoliosis screening is 10-14 years old when growth spurt is occurring. This study was performed on 936 students between 10-14 years old in Shahrekord. Diagnosis was based on observation of asymmetric anatomical landmarks [such as spinout process, pelvic and shoulders], Adam's forward bending test and radiographic measurement of Cobb's angle. Eighty-six persons out of 936 were referred to orthopedic clinic. Seven cases had idiopathic scoliosis, 5 females and 2 males. Two persons had thoracic, 4 had thoracolumbar and 1 had lumbar congenital curvature. Two patients had family history of scoliosis and overall prevalence of idiopathic scoliosis was 0.7%. During exercise all 7 patients got tired sooner than their classmates and had higher incidence of back pain. Two girls and one boy needed surgery. Also 3 girls and 1 boy needed Brace treatment. Using this method, the patients can be recognized easier and more rapidly. Therefore, both the curve progression and dysfunction of limb are inhibited leads to decrease need for surgery

[Comparative results of non-surgical long term treatments of tennis elbow disease]

Tennis elbow or lateral epicondylitis disease is caused by overuse of forearm muscle, and tension of carpi radialis brevis tendon. Since there are no accepted criteria for treatment of the disease, this study was conducted with the aim of comparative efficacy of four non-surgical treatment procedures in Shahrekord in 2003. This double blind clinical trial investigated the efficacy of four non-surgical procedures in 120 patients [4 groups of 30] with mean age of 37 as follows: 1] local corticosteroid injection [20 mg of methylprednisolone + lidocaine], 2] administration of NSAID [500 mg of naproxen b.i.d for 2 weeks], 3] forearm supportive bands, 4] physical therapy and progressive exercise. The elbows of all patients were immobilized by cast for two weeks and they were advised to avoid repetitive arm movement for 21 days. The first evaluation was carried out before treatment and the data were recorded. Overall recovery evaluation was conducted in the 1st, 3rd. 6th and 9th. months post - treatment through a 24-score standard and the data were analysed using SPSS version 12 software and paired t test. In the first evaluation the mean calculated score was 19.04 for all groups. In post-treatment period the results were as follows: by the end of the first month the scores for 4 groups were 6, 8, 11 and 12 respectively, by the end of the 3rd month 9, 11, 8 and 8 respectively; by the end of the 6th month 9, 8, 6 and 5 respectively and by the end of the 9th months 8, 8, 5 and 3 respectively. Differences In mean score were statistically significant except the 3rd month which showed no significant difference [p=0.05]. Furthermore, final score of the first month showed the highest difference in corticosteroid-treated group with pre-treatment period compared to other groups [p=0.001]. By the end of the 9th month the change in final score in physical therapy group was the highest which showed a significant difference [p=0.005]. Local injection of corticosteroid is an effective method to relieve the pain in patients suffering from tennis elbow. However, recurrence of the disease is common during a tree-month period and the results at the end of the 9th month in physical therapy and exercise group is promising. Thus, the choice nonsurgical treatment for the disease is probably the initial corticosteroid injection followed by long term physical therapy

[Epidemiological analysis of head trauma in patients admitted to Kashani General Hospital, Shahrekord, June 2000-May 2001]

Head trauma can result in severe disabilities and problems for patient, families and society. Trauma is the third most common cause of mortality and disability, and more than 50% to 70% of the mortality is due to head trauma. The aim of this survey was to search for epidemiological, etiological and radiological findings in 1510 patients admitted to Kashani General Hospital from June 2000 to May 2001. The patients consisted of 74.1% males and 25.9% females, and 25% of them were 11-20 years old. The main reasons for admission was falling [33%], car accident [29%] and assault injury [15%]. With respect to the consciousness level, according to Glasgow Coma Scale [GCS], the patients were divided to severe [4.5%], moderate [6.9%] and mild [88.6%]. 58% of the patients had multiple traumas. High percentage of trauma in the second decade of life, trauma with contact mechanism [e.g. compound depress fracture] and assaults injury [15%] were peculiar to this survey. Overuse of X-ray [in more than 78%, with less than 5% positive findings] and CTS [with 84% normal report] in these patients highlight the need for revising of the use of these techniques. Since there was a high percentage [53%] of mortality among patients referred fibni other centers, the diagnostic and treatment facilities of the referring centers should be improved