[Trauma epidemiology and its consequences in victims referred to Kashan trauma center during 2007-8]

Trauma is the most common cause of mortality for people aged 1 through 44 years. Traffic accidents are the leading cause of severe injuries among young people in most countries. This study was conducted to determine the frequency of traffic accident injuries in victims referred to Kashan Trauma Center during 2007-8. This cross-sectional descriptive study was carried out on 1004 trauma cases referred to Kashan Shahid Beheshti Trauma Center during the year during 2007-8. Data including age, sex, type of trauma, and type of intra- and/or extra-thoracic injury were recorded and analyzed. Sixty-six per cent of the cases were male, and the most frequently observed trauma cases were between the ages 21 and 30, followed by 10 and 20. The frequency of trauma in urban and rural areas was 62.5% and 37.5%, respectively. Motorcycle accidents are the most common traffic accidents followed by car accidents. Considering the large number of trauma cases secondary to the traffic accidents and lower levels of education in those cases, appropriate educational programs may be helpful to decrease the mortality rates and other undesirable consequences of accidents

[Intravitreal bevacizumab [avastin] injection alone or combined with triamcinolone versus macular photocoagulation as primary treatment for diabetic macular edema; an interim analysis]

To report the efficacy of a single intravitreal injection of bevacizumab [IVB] alone or in combination with intravitreal triamcinolone acetonide [IVT] versus macular laser photocoagulation [MPC] as primary treatment for diabetic macular edema [DME]. This randomized three-arm clinical trial included 103 eyes of 97 patients with clinically significant DME and no previous treatment. The eyes were randomly assigned to one of the three study arms: the IVB group received 1.25 mg IVB [37 eyes], the IVB/IVT group received 1.25 mg IVB together with 2 mg IVT [33 eyes], and the MPC group underwent focal or modified grid laser photocoagulation [33 eyes]. Primary outcome measure was change in best-corrected visual acuity [BCVA]. Changes in BCVA [logMAR] at 12 weeks were -0.22 +/- 0.23, -0.13 +/- 0.31 and +0.08 +/- 0.31 in the IVB, IVB/IVT and MPC groups, respectively. The marginal regression model based on generalized estimating equation analysis demonstrated that changes in visual acuity was statistically significant in the IVB group at both 6 [P<0.001] and 12 [P=0.024] weeks but only at 6 weeks in the IVB/IVT group. Significant decrease in central macular thickness [CMT] was observed in the IVB and IVB/IVT groups at 6 weeks. Up to 12 weeks, IVB treatment in eyes with DME yielded better visual outcome than laser photocoagulation, although it was not associated with a significant decrease in CMT. IVT seemed to have no further beneficial effect in combination with IVB

[Patient satisfaction with outpatient/inpatient ophthalmologic services at labbafinejad medical center]

To assess patient satisfaction with ophthalmologic services at Labbafinejad Medical Center. The present study was a cross-sectional study conducted during the summer of 2008. Patients with ophthalmic problems were selected by systematic random sampling according to the admission list. A trained investigator interviewed patients in the hospital or clinic. The data collection tool was based on a standard PSQ-18 questionnaire. Primary outcomes were measured as the level of satisfaction domains on a 5-point scale [1 = lowest satisfaction, 5 = greatest]. Of 539 patients [98% response rate] with mean age of 44.7 +/- 23 years age, 167 patients [31.2%] were completely satisfied, 215 [39.9%] were satisfied, 95 [17.5%] were partially satisfied, 29 [5.2%] were unsatisfied, and 33 [6.2%] were completely unsatisfied. The mean score and standard deviation of general satisfaction was 4.05 +/- 1.1. Mean score in different domains of satisfaction were as follows respectively, interpersonal manner [doctor-patient] 4.6 +/- 0.77, financial aspects 4.5 +/- 1.1, communication 4.3 +/- 0.96, time spent for patient 4.3 +/- 0.97, technical quality and professionalism 4.1 +/- 0.99, accessibility 3.8 +/- 1.1, and convenience 2.6 +/- 1.2. The patients were relatively highly satisfied with the ophthalmologic services overall; however, certain aspects such as accessibility and convenience should be improved

[Evaluation of safety devices used in work-related eye injuries]

To report and evaluate the characteristics of patients referred to the emergency department of Labbafinejad Medical Center with work-related eye injuries during 2005. In this descriptive study, an available sample of patients with work-related eye injures were assessed. Demographic characteristics, causes of ocular trauma, and use of work safety devices were main evaluated variables. Overall, 99 subjects [96% male] with mean age of 31.76?10.55 years were enrolled. Mean time interval between the accident and referral to eye emergency was 2.46 +/- 4.46 days [0-30 days]. Of these, 66.6% came to the emergency ward on the first day after the incident and 37.1% underwent an eye examination at this center for the first time. The most unsafe activities were grinding [21.4%], welding [20.4%], hammering work [14.3%] and manual work [10.2%]. Metal industrial [50%], constructional [17.3%] and mechanical [8.2%] workers had the highest risk for eye injury among different occupations. The major consequence of eye injuries was corneal foreign bodies [72.7%]. Of injured patients, only 14 persons [14.1%] had passed job safety educational courses and 93 persons [93.9%] had not used any eye protection device. Most injured patients were young men workers using no safety devices; therefore it seems that occupational safety efforts including eye protection education and training programs in this context is insufficient

Comparative evaluation of preoperative CT Scan and intraoperative endoscopic sinus surgery findings in patients with chronic rhinosinusitis

Chronic rhinosinusitis [CRS] is a common condition in medical practice. The diagnosis generally relies on clinical judgment, but computed tomography [CT] together with sinonasal endoscopy, provide the majority of the objective data. This study was carried out to determine the agreement between preoperative CT findings and intraoperative endoscopic sinus surgery [ESS] findings in patients with CRS. Statistical analysis of collected data from paranasal sinus CTs of 51 patients aged between 15 and 77 who subsequently underwent ESS for CRS at two training hospitals during a 2-year period, was performed. The agreement between CT and ESS findings was assessed by Kappa statistics, Chi-square and t test were also used for data analysis. The most common co-morbidity found among the patients with chronic sinusitis was allergy in 18 [35%] patients. Hypertrophy of the inferior turbinate was the most obvious finding in CT [71%] and during endoscopic evaluation [69%]. No significant correlation was found between clinical symptoms and gender or the length of disease. In 8 unusual patients [one with choanal atresia, one with bone wax in nasal cavity, and 6 with small polyposis], CT could not show the problem. There are good to excellent agreements between the two diagnostic procedures, except for the choanal atresia, which showed no agreement [K = 0]. The results of nasal fossa findings obtained by nasal endoscopy are more conclusive in the elucidation of diagnosis than those obtained by paranasal sinus CTs. In spite of a good agreement between CT and ESS findings in most patients, it seems in some unusual cases, CT may miss many patients

[Comparison of oral micro flora and coronary artery disease]

Cardiovascular disease is the most common cause of death in developed counteries and it's morbidity and mortality is also increasing in Asia. Hypertension, hyperlipidemia and smoking are majore risk factors of atherosclerosis. In recent years infectious agents such as clamidia pneumoniae, Helicobacter pylori and dental flora infections seems to be effective in development of atherosclerosis. This study was designed for finding possible relation between dental flora and coronary artery disease.This was a case-control study [40 case and 40 control patients]. Case group were the patients with 75%-one vessel coronary stenosis in angiography and control had normal angiography, oral samples were provided for microbial culture in 2 groups, and data were analyzed.Frequency of streptococcus viridance, streptococcus beta-hemoliticus, pneumococcus, gram-negative staphylococcus, gram-positive staphylococcus, Nisseria and diphteriod was 82.5, 15, 2.5, 12.5, 7/5, 17.5 and 5 percent in case group and 37.5, 27.5, 7.5, 5 and 7.5 percent for control group, respectively Statistical test showed significant difference between frequency of streptococcus viridance in case and control group. This study suggests a probable relation between streptococcus viridance and coronary artherosclerosis disease, so prophylaxis can be recommended for this purpose