ABSTRACT
Objective: to determine the economic burden of road traffic accidents [RTAs] in patients admitted to a single center in south eastern Iran
Methods: this cross-sectional study was conducted in Amir-Al-Momenin hospital of Zabol affiliated with Zabol University of Medical Sciences during a 12-month period from April 2012 to April 2013. All the RTAs patients who were admitted to our emergency department were included. The direct expenses of hospital care were recorded according to their medical charts and the accountant registration information. Data are presented according to different RTAs characteristics
Results: overall 1155 patients were included in the current study with mean age of 36.7 +/- 5.14 years among whom there were 673 [58.3%] men and 482 [41.7%] women. The annual incidence of RTAs were calculated to be 288 per 100,000 population. The RTAs economic burden in our center was 589,448.49 USD which accounted for 10.4% of total hospital expenses during the study period. The money spend on RTAs in our center was 130 times more than gross national income per capita. Cost of each patient in road traffic was 15 times more than cost of an average patient of the hospital in other sections
Conclusion: with considerable high ratio of accidents in Zabol, proper intervention is needed for controlling and preventing RTAs in order to decrease its injuries, impact and the associated economic burden
ABSTRACT
Background & Objective: It is reported that acute forced swimming stress induces analgesia immediately, and chronic stress induces hyperalgesia. Whereas in response to nociceptive stimulation, small-diameter C-fibers of the excitatory system in the dorsal horn of the spinal cord are activated, therefore, in the present study, the effects of C-fiber lesion in stress and dexamethasone-induced analgesia and hyperalgesia in acute and chronic forms were investigated using Tail-Flick test. Methods: Adults Wistar male rats (180-200 g) were assigned into three groups (n=7): C-normal (intact C-fibers), sham (received capsaicin vehicle at neonate stage) and C-lesion (received capsaicin at neonate stage). Forced swim stress (10 min/day) in water (18±1 ºC) was considered as acute stress and repeated daily forced swim stress as chronic stress, also single-dose of dexamethasone (2 mg/kg, i.p.) was considered as acute dexamethasone and repeated for three days as chronic dexamethasone. Neonatal capsaicin treatment was used for C-fibers depletion. The nociceptive thermal threshold was assessed using Tail-Flick test. Results: In C-lesion group, thermal pain sensitivity was reduced (P<0.001). Acute stress in C-normal group, reduced pain (P<0.001) and in C-lesion group, it caused deeper antinociception in Tail-Flick (P<0.001). Chronic stress and acute-chronic dexamethasone in C-normal group, created hyperalgesia (P<0.001) and induced analgesia in C-lesion groups (P<0.01). Conclusion: It seems that presence of C-fiber is so important in thermal pain transmission in Tail-Flick test; therefore, C-fiber lesion, reduces pain sensitivity (analgesia), increases antinociception effects of acute stress, decreases hyperalgesia of chronic-stress and acute-chronic dexamethasone
Subject(s)
Analgesia , HyperalgesiaABSTRACT
Aspergillosis is a rapidly progressive, often fatal infection that occurs in severely immunosuppressed patients, including those who are profoundly neutropenic, recipients of bone marrow or solid organ transplants and patients with leukemia, lymphoma, advanced AIDS or phagocytic disorders such as chronic granulomatous disease. Patients with severe liver disease are at a higher risk for infections. Immunocompetent individuals rarely develop this infection and do so only in the presence of pulmonary and systemic abnormalities such as fibrotic lung disease, suppurative infection or when they are on corticosteroids. We present 2 cases of pulmonary aspergillosis in diabetic patients. They presented with cough and dyspnea. Aspergillus was found in obtained respiratory samples. Pulmonary aspergillosis was confirmed in our first case by transbronchial lung biopsy [TBLB] and Galactomannan assay. In the second case, diagnosis of pulmonary aspergillosis was established by thoracic CT guided biopsy plus Galactomannan assay. These patients had none of the suggested risk factors for Aspergillus infection but they had uncontrolled diabetes mellitus. This report highlights that pulmonary aspergillosis can occur in individuals with diabetes mellitus even in the absence of other risk factors such as corticosteroid use, severe granulocytopenia or other associated immunosuppressive factors. It is; therefore, valuable to recognize that in patients with diabetes mellitus pulmonary aspergillosis should be considered as an important differential diagnosis for respiratory problems