Injuries associated with landmines and unexploded ordnances in Iran

Although in the last few years there has been increasing awareness of the problem of landmines, there are still an increasing number of people especially children, illed and injured by landmine every week in the world including Iran which is estimated to have the second rank for landmine injuries. Eighteen years after cessation of Iraq-Iran war, the provinces located near the west border of Iran still suffer from the burden of vast areas highly infested with Landmines. This study aims to gather more information on the particulars of mine associated incidents and victims. This is a retrospective study of people with documented deaths or injuries due to landmine and/or unexploded ordnances [UXO] explosions, as documented in their medical files between Jul 1988 [after ceasefire] and Feb 2003. 3713 victims from 3 main organizations in charge of providing health care services for them were included in this study. Of these, 3461 [93.2] were male, and 252 [6.8%] were female. Most of the victims were civilians and the majority of them [40.4%] had one or more amputations. Most of the patients were injured in the period between1994 and 1998. The majority of them were young, and 41.8% were children. The occurrence of death and injuries due to landmine in Iran is regrettably high; this places a significant burden on the health care system, rendering increased commitment of the government a must. Collecting data on accident particulars and landmine victims can provide meaningful information on the risk factors

Women pose innocent victims of landmines in postwar Iran

Although in the last few years there has been an increasing attention to the problem of landmines, to date, the implications of women being victims of landmine has not been duly dealt with in the world including Iran, which is estimated to be the second most landmine infested country in the world. Still, provinces by the west border of Iran, 18 years after cessation of Iraq-Iran war suffer from the burden of vast areas, highly infested with landmines. This study aimed to provide a gender focused insight into landmine accidents in. In this retrospective study, women with documented deaths or injuries due to landmine and/or unexplodeda ordnances [UXO] explosions as documented in their medical records between Jul 1988 [after ceasefire] and Feb 2003 were studied in 5 western provinces of Iran. Data was analyzed by SPSS for Windows Version II.P value under 0.05 was considered statistically significant During the 14-year study period, 252 women from 5 western provinces of Iran were reported to have injuries or death due to landmine and UXOs. All of the victims were civilians and the majority of them [47.6%] had one or more amputations. Most of them were injured in the period between 1994 and 1998. The majority of the patients were young. Women who should take care of themselves as well as their families are more prone to sufferings inflicted by landmines and UXO

Gastric pull-up reconstruction for pharyngolaryngoesophagectomy in head and neck cancer and cervical esophageal squamous cell carcinoma

There are many techniques for reconstruction after total pharyngolaryngoesophagectomy. The use of a transposed stomach to restore gastrointestinal continuity, and this combined cervical and abdominal approach for pharyngolaryngoesophagectomy and gastric pull up has become one of the most popular. This retrospective study is a review of 50 consecutive Iranian patients who underwent pharyngolaryngoesophagectomy and gastric pull up in Amir-Alam Hospital affiliated to Tehran University of Medical Sciences, to determine the complication and survival rates. The clinical data of 50 consecutive cases of cervical esophagus carcinoma and squamous cell carcinoma of the hypopharynx treated by pharyngolaryngoesophagectomy and gastric pull-up were analysed. The age, gender, operating room time, operative mortality, major postoperative complications and survival rate were retrieved. Survival time was studied using Kaplan-Meier method. The postoperative complications were wound infection in five patients, pulmonary complications in ten, Stomal stenosis in six, cutaneous fistula in four, Gastric outlet obstruction in three. There were no intraoperative deaths. One month mortality was 10 per cent. The median survival for patients who underwent pharyngolaryngoesophagectomy and gastric pull-up procedures was 21 months and the 5-year survival was 18%

Trauma mortality in six university hospitals: Tehran, Iran

Trauma is the most common cause of mortality in the first four decades of life. In our country, cardiovascular diseases and trauma are leading causes of mortality, respectively. By gathering information on trauma mortalities, we can learn more about causes, and that knowledge can lead to prevention. This is a prospective descriptive study in Tehran during 12 months period [Sep 1999- Sep 2000]. Two hundred and forty five trauma deaths in six hospitals were evaluated. The data was collected through a questionnaire, designed in Sina Trauma and Surgery Research Center [STSRC] used for the study. The questionnaires were completed by trained physicians visiting trauma patients in emergency room and wards round the clock. Data obtained included patient demographics, level of prehospital care, medical and operative procedures performed in emergency rooms [ER] and wards [according to ICD-10 coding], Glasgow Coma Scale [GCS] and vital signs at time of presentation to emergency rooms, Injury Severity Score [ISS], length of hospital stay and outcome of patients. Twenty and forty five [3%] of 8000 trauma patients was died. Mean age was 40.7 [ +/- 23.5] years old and 208 [84.9%] patients were male. The highest mortality rate was seen in the age group of 25 to 30 years. Road Traffic Accident was the main cause of death followed by falling with 174[71%] and 41[16.85], respectively. Among victims of road traffic accident, pedestrians and motorcyclists were prominent with 119 and 28 cases respectively. The majority of cases were dead due to head injuries [69%] and abdominal trauma was the second cause with 19 [7.8%] cases. Based on our findings the mechanism of injury have the positive effect on trauma outcome. Traffic accidents and assault is preventable and must be attended

[Mechansim and outcome of hip fracture: a multi-center study]

We aimed to demonstrate the mechanism of fracture and functional outcome of patients with hip injury in our clinical setting. In a historical cohort, all women 50 years of age and older admitted to three university hospitals of Tehran University of Medical Sciences [Shariati, Imam Khomeini and Sina] with the diagnosis of hip fracture from 21 March 2003 to 21 March 2004 were included in this study [n=115]. Follow up was conducted via telephone post and even home visit to record the functional status of the patients at the time of study [5 Jan 2005] measured with Barthel index in addition to the exact mechanism of injuries. The mean and standard deviation of age were 76.3 _ 10.6 years. About 88.7% of injuries had occurred at home [65.2% on the carpet], the remaining happening in the streets. Mean length of hospitalization was 11 _ 7.9 days. Among our patients, 71% could mobilize spontaneously without aids before injuries. This had reduced to 20% at the time of follow-up. The mean Barthel index was 97.2 _ 8.2 before fracture and 75 _ 21.1 at the present. Among our patients, five cases died during hospitalization and 29 of them died afterwards [total: 34 or 29.6%]. The most common external cause of injuries in our cases was stumbling at home especially on carpeted surfaces. This necessitates preventive measures aimed at physical standards of houses and education of elderly on healthy locomotion, indoors

Pattern of motorcycle-related injuries in Tehran, 1999 to 2000: a study in 6 hospitals

We studied motorcycle-related injuries in Tehran from 23 August 1999 to 21 September 2000 in 6 hospitals. Data were obtained from the trauma registry and questionnaires completed by trained physicians. Of a total of 8500 patients with trauma injuries, 1332 were motorcyclists, with a male to female ratio of 15:1. Of these, 1226 patients were driving the motorcycle at the time of the accident and 75 were pillion passengers. Crashes involving another vehicle were the commonest kind of accident [72.5%]. Helmet use was noted in only 8.6% of cases. There were 28 fatalities and head injuries were the prominent cause of death. Of those who died, none had been wearing a helmet at time of the crash. Only 2.7% of helmeted riders sustained a head injury, compared with 11.2% of riders without a helmet. The commonest musculoskeletal injury was fracture: tibial fracture with 509 cases [49.8%] comprised the largest proportion

[Pattern of firearm related injuries: results of a multi-center study]

Firearm-related injuries pose a serious public health problem in many countries, such as the United States and South Africa. The aim of this study was to report the pattern of firearm injuries using data collected by the national trauma project. The national trauma project has been conducted by Trauma and Surgery Research Center of Sina Hospital in 8 cities of Iran [Tehran, Shiraz, Tabriz, Ahvaz, Kermanshah, Mashhad, Babol and Qom] and it includes information of 16753 trauma patients. Overall, 104 patients [0.6%] were identified as having sustained a firearm injury. They were 94 [90.4%] males and 10 [9.6%] females, with a mean age of 28.2 +/- 10.3 [range, 15 to 60 years]. The age group of 21-30 years comprised 49.5% of our patients. Extremity injury was the most common type of injury [47.9%]. Eight patients [7.6%] died resulting from the severity of injuries, with head injury as the main cause of death in 4 of them [50%]. Most patients [73.3%] sustained injuries in an assault. More restricted rights toward keeping and using firearms seem to be necessary. Awareness of physicians of firearm related injuries and their treatment is essential for the appropriate management of patients and reduction of hospital mortality in victims. On the other hand, attempts should be made to build an especial system for monitoring firearm-related injuries in Iran

Injuries caused by falls from trees in Tehran, Islamic Republic of Iran

Although falls from trees are rare, the consequences can be severe. Over 13 months in 6 hospitals in Tehran 49 [0.57%] of 8500 registered trauma patients had fallen from trees. The mean age was 31 years [range 6 to 74 years] and 21 [42.9%] were aged < 20 years. Home and recreational/sports grounds were the most common sites of trauma. Most falls occurred during leisure time; only 3 [6.1%] were occupation-related. Eleven patients [22.4%] sustained a fracture of the spinal column; 2 of them became permanently paraplegic and 2 others who had severe thoracic vertebral fractures and paraplegia on first observation were transferred to other hospitals for treatment. Due to the severity of this type of injury, especially among the young, effective preventive efforts may be necessary