Surgical emergency room workload charecteristics: single center experience during one year

Having information on characteristics of work load of emergency surgical room in 3 working-shifts per day help to manage facilities and health care providers more efficiently. The aim of this study is to evaluate the workload pattern of 3 working-shifts of a day in Nemazee Hospital, southern Iran. The patients who were admitted in the surgical Emergency Room from April 2007 to May 2008 were enrolled including the patients' demographics, referral sources, the busiest working-shifts and the type of procedures performed in the Emergency Room. 33,837 emergency surgery referrals were recorded, of which 74.7% were male and 25.3% were female with a mean age of 30.8 +/- 20.1 years. The busiest working-shift of the day was between 8.00 PM and 8.00 AM, when 48.4% patients were admitted. 12.1% were admitted in the Emergency Room while 4.8% patients were admitted in the hospital wards and 5.6% underwent emergency surgery. 32.4% of them were discharged while 39.7% left the hospital with their own responsibility and 4.7% patients escaped from the hospital. The total number of the deaths during the study period was 0.7%. Our results showed that patients were mainly male teenagers and most of the accidents happened by motorbike during the busiest working-shift of the day from 8 PM to 8 AM. Therefore, it would be useful to persuade health system administrators to set up some educational programs to increase the awareness of families and teenagers regarding trauma and also to allocate more resources to shorten waiting lists

Tuberculous involvement of the thyroid

Despite increasing detection rates of various forms of extrapulmonary tuberculosis [TB], thyroid involvement with tubercle bacilli is rarely encountered and its imaging features have been reported in less than a handful of cases. Herein, we present the clinical, pathologic and imaging [ultrasound and CT scan] features of TB involvement of the thyroid gland in a 65-year-old woman who presented with a painful and rapidly enlarging thyroid mass. While reviewing fine needle aspiration results, the diagnosis of TB should be borne in mind, especially in the presence of imaging findings of a peripherally enhancing thyroid mass or thickening of the adjacent musculature and skin, the so-called dermal sign