ABSTRACT
Objective: To determine the status of pre-hospital emergency care and its associated factors in traumatic patients
Methods: In across-sectional study, 577 traumatic patients who were transferred to Poursina hospital by EMS [Emergency Medical Services] personnel were selected by simple random sampling method. Pre-hospital emergency services were observed. Then the mean of taken measures scores for each domain was determined in percent and evaluated in terms of associated factors [age, working experience of staff and number of missions per day] and compared using Spearmans test
Results: Out of 577 patients, 454 were men [78.7%] and 123 women [21.3%]. Their mean age was 35.1 years old. Accident [82.7%] was the most common mechanism of injury. Most vehicles involved in the accident were light-weight cars [48.5%] and motorcycles [32.2%]. A significant relationship was found between age, general domain [p=0.039] and hemodynamic [p=0.019] as well as between work experience and general domain [p=0.018]
Conclusion: Given that pre-hospital emergency services provided in most of the domains are relatively far from world standard, results of this research can provide information for managers to improve strategic planning on care and medical services, appropriation of budget, knowledge of personnel and necessary equipment
ABSTRACT
Objective: To determine the epidemiological characteristics of the road traffic injuries [RTIs] in Guilan province, northern Iran
Methods: This study was a cross-sectional study which included all of RTIs admitted to medical centers of Guilan province [northern Iran] during 2012. ICD-10 was used as diagnostic criteria. Demographic variables also injury circumstance and in hospital variables such as length of stay, time of admission, type of surgery, ICU admission, final outcome and mechanism of injury, anatomical part of injury according to Abbreviated Injury Scale [AIS] classification were derives from records by trained research team. Descriptive data is reported
The predictors of mortality were also determined
Results: The prevalence of road traffic injuries in Guilan province was 31 in 10,000 populations. Of total 7671 accidents, 5976 [77.9%] were men and 1695 [22.1%] were women. Mean age of these victims was 33.3+/-17.289 years [32.64+/-16.939 for men, 35.62+/-18.312 for women]
Most of them [32.5%] were 20-29 years old. Motorcyclecar accidents had the highest frequency followed by car-car crashes and car accidents involving pedestrians
Most of the patients [85.9%] were hospitalized and 280 injured died [3.7%]
Upper extremities were the most sites of injuries. Male sex, length of hospital stay, multiple injuries and increased age were associated with road traffic accident associated mortality
Conclusion: RTIs cause enormous death and disability in this area and more road traffic preventive programs should be enforcement in these areas to reduce incidences RTI
ABSTRACT
Background and Aim: traumatic subdural hygroma is the accumulation of CSF [cerebrospinal fluid] in subdural space following head trauma. The mass effect of hygroma on brain can impinge on consciousness. There are still many ambiguities on indications of hygroma surgery. This is an 11-year follow-up study which involves the patients suffering traumatic subdural hygroma who underwent surgery
Methods and Materials/Patients: in this retrospective study, clinical records of 16 patients who were operated due to traumatic subdural hygroma were studied. The data from existing records in the hospital were collected and analyzed. They were then analyzed by Repeated Measures ANOVA using SPSS [Version 18]. The differences were considered statistically significant at P
Results: in this study, there were 13 men [81.3%] and 3 women [18.7%] [Mean age=62 years old]. In 87.75% of patients, hygroma was diagnosed 6 days after head injury. It wasunilateral in majority of patients [56.3%] and located in fronto-parietal area [81.3%]. The most frequent concomitant injuries were contusions [25%] and subarachnoid hemorrhage [18.8%], respectively. GCS trend on admission and at discharge was significantly different fromthat of hygroma formation [P<0.05]. One-fourth of patients had recurrence of hygroma after surgery. All patients [except one] had good outcome
Conclusion: subdural hygroma is a delayed lesion and surgical treatment improves the level of consciousness [LOC] in afflicted patients
ABSTRACT
Background: Damage caused by traumatic brain injury [TBI] depends on the extent of primary and secondary damages. The latter can cause induced neurological inflammation by releasing pro- and anti-inflammatory cytokines and chemokines. Measurement of serum interleukin-6 [IL-6], as a pro-inflammatory cytokine, can be useful in predicting outcome in patients with TBI.
Materials and Methods: In a cross-sectional study, 44 patients with GCS/= 14 years, hospitalized in Poursina teaching hospital, were included in the study. Blood samples were collected from patients in the first 6 hours after the accident; and serum was tested by ELISA method for the determination of IL-6 levels. Patients' outcomes were recorded 6 months after head injury according to Glasgow Outcome Scale [GOS], and were divided in two good [GOS >/=4] and bad [GOS<3] outcome groups. Data were analyzed in SPSS software version18 using the Spearman's rho, independent-t test, Fisher Exact test and Mann-Whitney test.
Results: Comparison of IL-6 serum levels, in the two groups after 6 months of head injury, showed that mean serum levels of IL-6 in good outcome group was lower than bad outcome group [85.2 +/- 51.6 vs. 162.3 +/- 141.1, respectively] [P <0.03].
Conclusion: Elevated serum levels of IL-6 in patients with severe TBI, is associated with poor clinical outcome.
ABSTRACT
Comparison of the prevalence of Iodine Deficiency Disorder [IDD] in neonates and school children using two different WHO indicators. From 2006 to 2010, 119701 newborns were screened by measurement of serum TSH level by heel prick. Neonates who had blood TSH >/= 5 mIU/l were recalled for more evaluation. In the same period of time, urine iodine was measured in 1200 school-aged children. The severity of IDD was classified using WHO, UNICEF, ICCIDD criteria. Between 2006 and 2010 a total of 138832 neonates were screened in Guilan province and the total recall rate [neonates with TSH level >/= 5 mIU/l] was 1.8%. The incidence rate of Congenital Hypothyroidism [CH] was 1/625. The median urine iodine level in school-aged children was 200-299 micro g/l. Considering the WHO, UNICEF, ICCIDD criteria, Guilan province would be classified as a none-IDD endemic area. However, health care systems should pay attention to the iodine excess and the risk of iodine induced hyperthyroidism in this population
ABSTRACT
To determine the prevalence of Ecstasy use and high risk behaviors among college students in Guilan; Iran. We conducted a cross sectional study of a representative sample drawn from college students [3958 students] of Guilan in 2005. The questionnaire was adapted from a number of the questionnaires used in the United States and the European countries. Data were analyzed performing chi [2] test and logistic regression. Out of 3958 students, 3700 students [93.5% responded, 1966 students from private colleges and 1734 students from state universities. The mean age of student was 224.2 +/- 3.5 years [ranging from 18 to 46 years]; and 49% were males. The life-time prevalence of Ecstasy use was 4.2% [157 students]. Ecstasy use was significantly associated with gender, other substances us, cigarette smoking, participation in friendly parties, sharing home with friends, alcohol consumption, type of university, educational level of family, family situation and history of educational abruption in last years [chi [2] test, p<0.0001] but not with age and university courses. However, logistic regression analysis indicated that the factors influencing Ecstasy use were use of other drugs, alcohol and cigarette smoking [P<0.0001]. Ecstasy use appears to be a serious problem in college students. Whatever the causes behind the rise in Ecstasy use, personalized and informative educational programs should be conducted in all colleges